Revision shoulder arthroplasty has been, until now, an uncommon procedure for most shoulder surgeons. It is becoming more frequent as the number of implanted primary shoulder replacements grows. With the development of reverse polarity replacements, and a wider selection of components available to the surgeon to help address complex bone loss, we are able to find more reliable solutions for patients with failed shoulder replacements who may previously have had to live with their symptoms. This article will review the current indications, work-up, decision-making, and outcomes of revision shoulder arthroplasty.