Purpose of Review <p>This paper presents a thorough review of the management of patients requiring revision of a previously placed artificial urinary sphincter. The symptoms at presentation and clinical evaluation, along with surgical techniques, are described in detail.</p> Recent Findings <p>Fortunately for the urologic surgeon, revision and replacement of the artificial urinary sphincter is an uncommon event. Recent research on the procedure focuses on strategies to prevent future revision surgeries, such as a modified surgical technique or interposition of flaps or tissue substitutes between the urethra and the sphincter cuff.</p> Summary <p>Revision and replacement surgery for an artificial urinary sphincter is a challenging procedure requiring thorough pre-operative evaluation, detailed knowledge of the male perineal anatomy, and a surgical plan that includes multiple surgical approaches for any given patient. Future research should focus on the identification of patient factors and prevention of device complications to prevent or reduce the need for revision surgery.</p>