Various materials of artificial bearing surfaces are developed and applied to reduce wear and osteolysis and to improve the survival rate of total hip arthroplasty. The survival rate of artificial joint is affected by mechanical properties and biological response. The wear rate of alternative bearing surfaces as ceramic-on-ceramic, metal-onmetal, highly cross-linked polyethylene decreased significantly compared with conventional polyethylene, but longterm results are still under follow-up and several problems have been unsettled. Particularly acetabular component should be in appropriate position to reduce complications. Each bearing surface should be selected considering age, activity, obesity, underlying disease, and socio-economic state of patients because it has its own pros and cons.