Audible squeaking in total hip replacements with ceramic-on-ceramic bearings is a rare problem. Acetabular component orientation was compared for 17 squeaking hips and 17 matched controls. Ninety-four percent of control hips were in a range of 25° ± 10° anteversion and 45° ± 10° inclination, but only 35% of squeaking hips were in this range (P = .0003). Eight hips squeak with bending. Four hips squeak with walking, and 5 hips squeak after prolonged periods of walking. Hips that squeaked with walking had acetabular components that were more anteverted (40°) than hips that squeaked with bending (19°) (P = .001) or prolonged walking (18°) (P = .020). The hips started squeaking after an average of 14 months. Patients with squeaking hips were younger, heavier, and taller than patients with silent hips.