Extended trochanteric osteotomy (ETO), a procedure involving osteotomy of the greater trochanter and variable femoral diaphyseal bone length, is utilized during complex primary and revision total hip arthroplasty (THA) surgeries to provide extensile exposure of the femur and acetabulum. This chapter focuses on ETO’s indications, techniques, outcomes, and complications. Indications for ETO include femoral component extraction, cement removal, and enhancing acetabular exposure. Numerous techniques have been described. The two most common types are laterally and anteriorly based. Fixation methods include single- and double-looped wire, cable, and cable-plate. No consensus exists on the optimal technique. ETO demonstrates high union rates and improved patient-reported outcomes in short- to mid-term follow-up from preoperative state. Comparative results and long-term implant survivorship data remain limited. Complications associated with ETO include nonunion, fracture, and proximal migration. Postoperative rehabilitation protocols vary, with limited evidence supporting specific restrictions. In conclusion, ETO is a valuable tool for hip arthroplasty surgeons, offering extensile femoral and acetabular exposure and reliable outcomes in complex primary and revision THA procedures.