Low plasticity burnishing (LPB) is a surface enhancement method that produces a deep layer of compressive residual stress with minimal cold working and an improved surface finish. Extensive fatigue testing, performed on numerous metal alloys in simulated environmental conditions, demonstrates that LPB significantly improves fatigue strength of highly stressed components. LPB is a flexible process, capable of being implemented on a wide variety of CNC machine tools. A product-specific LPB process was developed and applied to the modular neck taper junction of a Ti-6Al-4V total hip prosthesis (THP). LPB produced a compressive residual stress field with an improved surface finish, which enhanced component fatigue strength and resistance to fretting damage. X-ray diffraction (XRD) residual stress measurements, made before and after LPB application, are shown. High cycle fatigue (HCF) results obtained on LPB-processed hip stems are shown along with baseline data for unprocessed hip stems. HCF tests demonstrate complete elimination of fretting fatigue failures in the LPB processed area of the taper junction and a substantial increase in overall THP fatigue strength.