Numerous steps are required to successfully complete a revision total knee arthroplasty. A review of the technical details of each step will be helpful to arthroplasty surgeons, along with a discussion of reoperative planning, complex surgical exposure techniques, component removal, and the choice of prosthetic components. A review of common difficult issues, including bone loss, ligamentous instability, and management of the extensor mechanism, will also aid in achieving a successful revision total knee arthroplasty.