Ankle replacement with contemporary devices may be an effective choice for treatment of the severely arthritic ankle in selected patients. As with any operative procedure, it is necessary to adopt criteria for defining the outcome and how to manage unsuccessful results. Salvage of failed total ankle arthroplasty (TAA) is challenging due to extensive bone loss, osteopenia, disturbed soft tissue envelope, and hindfoot pathology. A description of operations featuring implant removal and arthrodesis for failed TAA, including indications, preoperative planning, specific techniques, results, complications, and postoperative management is discussed.