Fretting is a form of adhesive wear normally occurring at the contact points gradually leading to premature of load bearing medical implants made of titanium alloys. The aim of this work is to characterize the fretting fatigue damage features of PVD TiN coated, plasma nitrided and thermally oxidized Ti-6Al-4V and Ti-6Al-7Nb contact pairs. Fretting damage is applied with calibrated proof ring and contact pad arrangement. The results are compared with fretting damage of uncoated alloys. The damage progression during fretting process is apparently explained with friction coefficient curves. Plasma nitrided pairs performed better in terms of fretting fatigue lives with low friction coefficient of friction. PVD TiN coated pairs have experienced early failures due to third body mode of contact interaction with irregular friction coefficient pattern. Thermally oxidized pairs have experienced early failures due to high case thickness as well as irregular development of modified layer. © 2005 Elsevier B.V. All rights reserved.