Purpose: To evaluate the bonding efficacy of 4-META/MMA-TBB resin to highly translucent zirconia subjected to various surface treatments. Materials and Methods: Highly translucent zirconia specimens (Zpex Smile, Tosoh; 11.5 mm diameter, 5.0 mm thick) were mechanically pre-treated to improve micromechanical interlocking either by sandblasting with 50-µm Al2O3 particles (Kulzer Japan) or subjecting the specimens to a low-pressure plasma treatment (PM100, Yamato), or evaluated using the as-sintered surfaces as controls. Next, specimens from each condition were primed with an MDP-containing primer (PZ Primer, Sun Medical), while some remained unprimed. All specimens were bonded to stainless rods using 4-META/MMA-TBB resin (Super-Bond, Sun Medical). The specimens were stored in ultrapure water at 37°C for 24 h, after which a portion were subjected to 10,000 thermocycles. For all specimens (n=10/group) the tensile bond strength (TBS) was determined with a universal testing machine. The measured values were statistically analyzed using Weibull analysis. Fractographic analysis was performed using a light microscope and an SEM. Results: After aging, Weibull analysis revealed significantly lower bond strengths for both as-sintered and plasma-treated zirconia without a primer treatment. The fractographic analysis showed that these two conditions resulted in a higher frequency of adhesive failure. Conclusion: Chemical pre-treatment with an MDP-containing primer improved bonding efficacy of 4-META/MMA-TBB resin to highly translucent zirconia. In addition, Al2O3 sandblasting resulted in durable bonding of 4-META/MMA-TBB resin to highly translucent zirconia, regardless of chemical pre-treatment. Keywords: highly translucent zirconia, alumina sandblasting, 4-META/MMA-TBB resin, Weibull analysis, MDP primer, tensile bond strength