Can I use a gemstone that isn't a diamond as the center stone?
Yes. You can use nearly any gemstone that isn't a diamond as a center stone, provided you understand what that stone is signing you up for. A sapphire will...
Yes. You can use nearly any gemstone that isn't a diamond as a center stone, provided you understand what that stone is signing you up for. A sapphire will do it. So will a ruby, spinel, tourmaline, or a well-cut moissanite. The mistake isn't choosing a colored stone. The mistake is treating every colored stone like a diamond with a tint.
I've set morganite, aquamarine, tanzanite, spinel, tsavorite, chrysoberyl, and enough Montana sapphires that I can tell you which shade of blue-green comes from Rock Creek versus El Dorado without looking at the parcel label. I've also refused exactly two center stone requests in 23 years. One was a fire opal for a woman who worked as a hairdresser and wanted a four-prong solitaire. She'd have snapped that stone within a year. She bought a diamond instead. I don't know which one of us was more relieved.
Hardness is not toughness
Sapphire and ruby sit at 9 on the Mohs scale. Diamond is 10. Those numbers sound close, and for scratch resistance they mostly are. But Mohs is about scratching, not surviving a hard knock against a car door or a granite countertop. A sapphire will shrug off daily wear that fogs a tourmaline, yet it will still chip if you slam it just right. Emerald sits at 7.5 to 8, and the same inclusions that give a fine Colombian emerald its garden also give it fracture lines. I set emerald centers almost always in a bezel, or in a six-prong head with V-tips protecting the corners.
For a daily-wear ring, the stones I'll set without much argument are sapphire, ruby, spinel, and chrysoberyl. That's my short list. Alexandrite is technically chrysoberyl, and a real one with a visible color change is rare enough that if you own one, you already know. These stones are tough enough to survive a normal life, and they'll keep their polish for decades. Montana sapphires are a particular favorite for engagement rings. They run steely blue, teal, or a greenish gray, and they cost less than an equivalent Ceylon or Burmese stone without hiding behind a treatment story.
Stones I'll set with a warning
Emerald, tanzanite, tourmaline, morganite, aquamarine, and opal can all work as center stones. They just need more protection and fewer assumptions. Tanzanite is 6.5 to 7, and it cleaves in one direction. One good knock in the wrong place and the stone splits like slate. Morganite and aquamarine are beryls, like emerald, but they're less included and still soft enough to scratch at the facet junctions within a few years of daily wear. Opal is the one I'll argue about because it's 5.5 to 6.5, full of water, and it loses play-of-color when it dries out or is exposed to heat, hand sanitizer, and dish soap.
Last March a client named Nicole came in wanting a 9x7mm pale pink morganite in a delicate four-prong setting. She's a sous-chef, hands in and out of sanitizer buckets eight hours a shift. Morganite runs 7.5 to 8. It's a pretty stone. It's also going to lose its polish and start showing scratches within a year or two of restaurant work. I told her. She argued. She'd seen the stone on Instagram. We went back and forth for a week, and the whole time she was still paying for a ring she didn't fully trust. She ended up with a pink sapphire a half-shade deeper, set in a six-prong 18k yellow head. It cost her about twice what the morganite would have. She texts me photos after every shift now. The sapphire holds.
Moissanite is a different conversation. It's not a colored gemstone, but it's the most common diamond alternative clients bring up. It's 9.25 on the Mohs scale, which puts it above sapphire and just below diamond. It's also double refractive, so its facets never look quite as crisp as a diamond's. I'll set it. I won't pretend it's a diamond, and I won't let a client call it one in the appraisal. If that bothers you, buy a lab-grown diamond. The price gap has narrowed enough that the difference is maybe a few hundred dollars, not a few thousand.
How to buy the right non-diamond center
Ask about treatment before you ask about carat weight. Most sapphires and rubies are heated. That's standard, and I don't lose sleep over it. But if a ruby is sold as unheated, I want a report from a lab that actually checks origin and treatment. GRS, SSEF, AGL, and GIA all do this work. A sapphire's origin is priced in: a Kashmir stone can cost five times what a Madagascar stone of the same color sells for, and you cannot tell them apart by eye. A Mozambique ruby that's unheated can cost double a heated one of the same color, and the only way you'll know is the report. That's not snobbery. That's the market, and you should know which one you're buying.
Setting choice matters more than most buyers think. For a softer stone, four prongs are not enough. I want six, or a bezel. A full bezel protects the girdle and the corners, and it does more for a tanzanite or emerald than any insurance policy will. If you're set on prongs, V-tips on the corners of a cushion or emerald cut are non-negotiable. I've re-tipped enough chipped emerald corners to know.
The honest version is this: a diamond is not the safest stone, just the most familiar. Sapphire is actually harder than most people think, and it doesn't have a cleavage plane the way diamond does. If a colored stone pulls you toward it, that's usually a better reason to wear it than someone else's resale math. Bring me the stone. I'll tell you what it can take.