Revision total hip arthroplasty (rTHA) requires precise determination of the anatomic hip center of rotation for favorable outcomes. Proper identification can be aided by anatomical landmarks that may be palpated and identified intraoperatively or alternatively located radiographically. It is important to take into account biomechanical factors including hip joint mechanics. With the rise of emerging technologies including computer-assisted navigation and artificial intelligence, new techniques are additionally being leveraged to improve surgical precision. This chapter will discuss landmarks and techniques to determine the anatomic hip center of rotation (COR) and review the literature and technical considerations involved in rTHA.