Hot isostatic pressing processed yttria-stabilized tetragonal zirconia polycrystal (HIP Y-TZP) has the potential for application to implants due to its high mechanical performance. The aim of this study was to investigate the influence of surface treatment of HIP Y-TZP on cyclic fatigue strength. HIP Y-TZP specimens were subjected to different surface treatments. Biaxial flexural strength was determined by both static and cyclic fatigue testing. In the cyclic fatigue test, the load was applied at a frequency of 10 Hz for 10(6) cycles in distilled water at 37°C. The surface morphology, roughness, and crystal phase of the surfaces were also evaluated. The cyclic fatigue strength (888 MPa) of HIP Y-TZP with sandblasting and acid-etching was more than twice that of Y-TZP as specified in ISO 13356 for surgical implants (320 MPa), indicating the clinical potential of this material.