Previous studies of metal on metal hip implants have shown that it is possible to obtain substantially lower volumetric wear than with metal on polyethylene pairings. To work toward design optimization, the gravimetric wear of serum lubricated, metal on metal implants was examined in a hip simulator apparatus. Seventeen implant specimens were fabricated from 3 alloys in various combinations of diameter and clearance and wear tested as many as 3 million cycles. Theory was developed to predict the thickness of elastohydrodynamic lubricant films, the linear wear, and wear zone geometry. To help interpret the data, implant diameter and clearance were combined into a single parameter called effective radius. Implants with larger effective radii (6-11 m) tended to experience lower wear, and theory suggested that this was a result of the correspondingly thicker elastohydrodynamic lubricant films providing an enhanced mixed film lubrication. As in most wear testing, the results were scattered but, overall, a low carbon, wrought alloy had lower wear than either a high carbon, cast alloy or a low carbon, commercial alloy. Because of the small number of specimens tested and possible variations in tribologic parameters such as calcium phosphate film formation and surface microgeometry, there was low statistical reliability of the results.