Low friction and wear resistant coatings have a long history of successful applications in industry. It has long been hoped that these coatings, especially diamond-like carbon (DLC), could also be used successfully in load-bearing joint implants, extending implant life time considerably. However, despite several medical studies carried out so far, no regular DLC-coated implants are available on the market. In most cases, failure was due to insufficient long-term stability of the adhesion of such coatings on implants in vivo. That is because introducing a coated implant not only brings the coating into contact with the body environment but also the interface that controls the adhesion. This usually reactively formed interface must be considered to be at least one additional material which must be not only bio-compatible, but also unsusceptible to corrosive attack. The aim of this paper is to analyze in detail the interface, i.e., the transition region between the substrate and the coating. This knowledge is necessary in order to find the right measures to ensure the long-term stability of the adhesion. Results for DLC coatings on a cobalt chromium molybdenum alloy are presented. It is shown that a very thin interface layer is formed, with the alloy on one side and the carbon film on the other side. This layer consists of a mixture of carbides from all the metals of the base material. This result is obtained by means of measuring depth profiles using X-ray photoelectron spectroscopy because these spectra yield not only the chemical composition of the interface but a detailed analysis provides information on the chemical states across the interface.