Femoral stem fracture is a challenging problem in revision total hip arthroplasty. Femoral stem fracture was a frequent complication of early cemented stem designs such as the Charnley-Muller prosthesis. Advances in modern femoral stem design have led to a significant reduction in the rate of femoral stem fractures; however, they can still occur. Fractures of both modular and nonmodular modern femoral stems have been reported in the literature and necessitate major revision surgery. Commonly reported patient-related factors increasing risk for femoral stem fracture include male sex, increased weight, and younger age. Technical factors frequently involve varus alignment and stem size, particularly small diameter tapered fluted titanium revision stems. Extraction of broken femoral stems presents a significant challenge during revision total hip arthroplasty. Proximal extraction is often ineffective, requiring advanced extraction techniques and often osteotomies.