Despite the low wear rate of ceramic–ceramic hip implants, hard-on-soft bearings remain the most commonly used bearings in North America and Western Europe. A major concern with ceramic–ceramic hip implants is the occurrence of squeaking phenomena, which are still not fully understood. Various factors are mentioned in the literature, but currently, studies mostly focus on only one specific parameter. The goal of this study was to systematically analyze four different factors (cup orientation, protein concentration of the test fluid, contact pressure and head roughness) that may influence the squeaking behavior of this bearing type. An in vitro simulation according to ISO 14242-1 was performed using an AMTI Vivo simulator, and acoustic signals were recorded. No squeaking occurred for any of the four parameters when bovine serum or water was used as the test fluid. Squeaking was observed only under dry conditions with the ceramic–ceramic bearing. Under dry conditions, the maximum resulting torque increased steadily, and squeaking occurred after approximately 300 cycles at a resulting torque of more than 22 Nm. Thus, the resulting torque might be one factor leading to squeaking and should be kept low to reduce the risk of squeaking.