Medical grade ultra high molecular weight polyethylene (UHMWPE) has been used as the bearing surface of total joint replacements for over four decades. These polymeric devices are susceptible to accumulated cyclic damage in vivo. Wear debris formation that ultimately leads to a need for revision surgery is linked to the plasticity, fatigue and fracture mechanisms of UHMWPE. This paper examines the deformation, yielding, fracture and fatigue behavior of conventional and highly cross-linked medical grade UHMWPE. Such properties play an important role in determining the long-term success of orthopedic devices. The mechanical properties discussed include the deformation behavior of UHMWPE, the yielding associated with quasi-static tension and compression, fracture toughness, cyclic loading, and fatigue resistance.