Extensive proximal femur bone loss presents a substantial challenge in the setting of revision total hip arthroplasty. Proximal femoral replacement (PFR) is a reasonable salvage treatment option in this clinical scenario. Methodical preoperative planning and precise surgical execution are crucial to enhance patient outcomes and minimize complications. The potential for complications is considerably higher with PFR compared to primary and other revision total hip arthroplasty procedures, with dislocation and infection being of particularly high risk.