A variety of different bearing surfaces have been used to avoid osteolysis following hip replacement. We report a retrospective review of medium-term results of a modern ceramic-ceramic bearing (Biolox, CeramTec, Plochingen, Germany) and uncemented components (Alpha Cera Fit Alphanorm, Lassnitzhohe, Austria) in 107 hip arthroplasties. The clinical outcome based on serial radiographs and scoring was assessed with a minimum follow-up of 7 years (mean, 7, 6 years; range, 7, 1-8, 3 years). The average age of the patients at surgery was 64, 6 + 11, 7 years (range: 21-88 years). The mean Harris hip score was 90, 4 (range, 84, 7-99, 2). Three patients with an extra long femoral neck experienced fracture of the ceramic femoral head, resulting in cessation of use of this combination. Radiological evaluation did not reveal any signs of lysis or loosening. Massive heterotopic ossification was seen in three patients. Medium-term follow-up showed excellent clinical and radiological results. Continued follow-up will be required to determine if this ceramic-on-ceramic bearing is associated with extended survivorship.