SummaryRevision surgery of failed intertrochanteric fractures is a challenging problem. The mode of failure is usually loss of fixation of the hardware with varus angulation and collapse at the fracture site. Concerns at the time of surgery include proximal femoral deformity, bone loss, compromised bone quality, and limb length discrepancy. Treatment options include revision internal fixation versus arthroplasty. The decision-making is primarily based on the status of the articular cartilage, the bone quality, and the activity level of the patient. Careful preoperative planning of the surgical procedure is extremely important and a good functional outcome can be anticipated in these patients.