Total hip arthroplasty (THA) continues to be one of the most successful operations in all of medicine. With this success the number of people undergoing THA has increased over the years and is only expected to exponentially increase over the coming decades. With the increased utilization of total hip arthroplasty for the treatment of end-stage osteoarthritis as well as the increased use of cementless fixation, especially in the elderly, there has been an increase in periprosthetic femur fractures. Arthroplasty surgeons are now tasked with treating these complex patients at increasing rates. The aim of this chapter is to review the author’s preferred technique for management of periprosthetic femur fractures with revision total hip arthroplasty.