In revision total hip arthroplasty, removal of a well-fixed femoral stem can often times be challenging. Two powerful surgical techniques, extended trochanteric osteotomy (ETO) or anterior cortical window (ACW), help gain access to the intramedullary canal and facilitate disruption of the bone–implant interface. These techniques are performed through an extensile direct anterior approach to expose the proximal and distal femur. Through careful pre-operative planning and surgical technique, well-fixed femoral stems can be removed in a controlled manner to maximize post-operative outcomes and minimize complications.