This study presents combined effects of couple stress fluids and rotational inertia together with considering lubricant viscosity variation with pressure in squeeze film characteristics of parallel annular plates. Squeeze film characteristics are obtained by combined solution of modified Reynolds equation and Stoke's microcontinuum for couple stress fluids with consideration of viscosity variation with pressure. Various cases of couple stress, inertial, and noninertial characteristics with isoviscous and piezoviscous contributions are investigated. The pressure distribution and load-carrying capacity for lubricant film are obtained in a closed form, using a small perturbation method. Furthermore, numerical solution of the film height versus response time is calculated employing the fourth-order Runge–Kutta method. The result shows that the combined effects of couple stresses and viscosity–pressure dependency improve the load-carrying capacity and lengthen the response time, as compared to the classical Newtonian lubricant with constant viscosity. However, increasing rotational inertia parameter decreases squeeze film characteristics.