OBJECTIVE This study was performed to characterize the natural history of squeaking sounds that occur following total hip arthroplasty (THA) using ceramic-on-ceramic bearing surfaces and its potential correlation with clinical and/or radiological results. METHODS This study included 47 patients who underwent THA between April 1999 and April 2005, and had at least 10 years of follow up from the time of the operation. Squeaking sounds were detected in 10 out of the 47 cases (21.3%). Squeaking-associated factors (i.e., cause, time of onset, inducing motions, and continuity of the sound) were assessed. RESULTS Squeaking sounds: i) were detected an average of 46.2 months after operation, ii) occurred more frequently in patients with a high body mass index (BMI) compared to those with low BMI, and iii) most frequently detected when deep flexion of hip joint followed extension. In all 10 cases, the squeaking sound remained through the follow up period; 6 cases experienced no change in frequency and pitch, 4 cases experienced a decrease in frequency and pitch over time. The cause(s) of changes to squeaking sounds could not be determined. CONCLUSIONS The frequency and pitch of the squeaking sounds changed over time in a subset of patients. The squeaking sound did not appear to correlate with clinical results or survival of the prosthesis.