Rotator cuff repair is one of the most common procedures performed in the shoulder. Predictable pain relief and functional improvements are seen across all age groups. However, anatomic healing of the surgically repaired tendon is not as consistent and has varied widely in the literature. The purpose of this article is to review the appropriate evaluation and management of patients with a failed rotator cuff repair, with specific emphasis on identifying proper surgical candidates for revision rotator cuff repair. This article also reviews the relevant surgical techniques, appropriate rehabilitation, and expected outcomes of revision rotator cuff repair surgery.