Failed surgical releases of the tarsal tunnel may be due to numerous causes. Many of the failures are due to lack of appreciation of the involved anatomy or inadequate technique. When an insufficient release is done, a revision simply completes the necessary steps. When external scarring is the problem, barrier materials may be used to help protect the nerve after neurolysis. When intrinsic damage is the problem, nerve wrapping, reconstruction, conduits, and nerve stimulators all play a role to restore function or ameliorate pain.