With an increasing incidence of rotator cuff repairs (RCRs), and by extension, RCR failures, surgeons must be facile in the diagnosis and management of this complication. A detailed history and physical exam as well as familiarity with the patient-specific, anatomic, and technical variables that increase a patient’s risk of RCR failure is critical. Modifiable factors should be addressed prior to revision RCR and non-modifiable factors should be examined as they may disqualify an individual from a revision attempt. A methodical surgical approach is critical. In general, outcomes following revision RCR are typically favorable although inferior than those following primary RCR.