This article describes the authors' approach to using extensively porous coated femoral components without cement in revision hip arthroplasty. Topics covered include preoperative evaluation, surgical planning, surgical approaches, implant removal, reimplantation, perioperative complications, and postoperative rehabilitation. The article stresses the importance of the quality of acetabular and femoral bone stock in planning surgery and of the postoperative rehabilitation program to achieve durable implant fixation.