Revision total hip arthroplasty (RTHA) is a complex procedure due to the multiple mechanisms of failure of primary implants. Tapered, fluted modular stems began with the Wagner stem in 1987. While the Wagner tapered stem began as a monobloc system, improvements in revision hip prosthesis designs have progressed the field of RTHA toward a modular approach, with a separate proximal body and distal stem. The modular tapered stems allow for distal diaphyseal fixation, beyond the site of failure. Modular designs allow for patient-specific optimization of version, offset, and limb length. The modular design is especially useful in RTHA situations where the metaphyseal and/or diaphyseal bone loss is significant. This is especially pertinent given that monobloc systems are not indicated for RTHA with severe bone loss, especially when distal to the isthmus. The purpose of this chapter is to describe the advantages, indications, complications, surgical techniques, and postoperative considerations of modular tapered stems.