This study is concerned with finding practical ways for strengthening metal/bone cement (M/BC) interfaces via surface alterations and identifying fundamental mechanisms underlying M/BC adherence. Shear strengths have been inferred from torsion tests using shear-lag analysis. The variables examined with regard to their effects on interfacial strength are substrate material, surface roughness, interface porosity, passivation and sterilization, surface cleaning procedures, and use of bone cement precoated metals. M/BC interfaces can be substantially strengthened by applying the bone cement to the metal with high pressure. This would be a practical way to strengthen interfaces for precoated implants. The acrylic polymerized in vivo would employ the usual low pressure method. Otherwise, the main method for improving M/BC interfaces is through changing surface topography. Cleaning or chemical treatments have relatively minor effects. Roughened surfaces, as expected, produce stronger interfaces. Dramatic strength improvements occurred with a porous arc plasma sprayed layer on the substrate. Surprisingly, highly polished surfaces also improve interface strength (compared to less polished surfaces). The hypothesis is advanced that M/BC adherence depends upon superposition of mechanical interlocking and atomic interaction effects, with the latter predominating for finer finishes and vice versa. Differences exist between materials which are independent of roughness.