Total femur replacement (TFR) is a form of salvage arthroplasty that can be used in the setting of failed total hip arthroplasty (THA). It is a complex procedure given the inherent mechanical limitations of the prostheses, significant associated soft tissue trauma and blood loss, and intensive postoperative rehabilitation. Optimizing long-term outcomes in this cohort relies on meticulous patient selection, thoughtful surgical technique, comprehensive postoperative rehabilitation, and proactive management of any postoperative issues. This chapter will serve as an overview of TFR with respect to indications, available implants, surgical techniques, and postoperative considerations. The primary focus will be on non-oncologic indications.