Posterior cruciate ligament reconstruction (PCLR) using autograft or allograft is performed in symptomatic patients, especially if associated with another ligament instability. A double-bundle reconstruction has been shown to be superior biomechanically without proven clinical superiority. Failure of a PCLR is most commonly due to graft tear, the incidence of which is about 11%. When symptomatic, a revision reconstruction is needed in order to relieve pain or instability. The diagnosis of the posterior cruciate ligament (PCL) laxity is made on clinical examination, but an MRI scan is needed to visualize a graft tear. Prior to revision, radiographs are needed to look at coronal malalignment, posterior tibial slope (PTS), and stress X-rays to quantify posterior or coronal instability. CT Scans are necessary to evaluate the previous tunnel position and dimensions and assess suitability for a one-stage reconstruction. Any varus in the presence of a lax posterolateral corner would need prior or simultaneous osteotomy. Similarly, a low PTS would need to be corrected since this has a profound effect on posterior tibial translation. Availability of grafts is a problem in any revision PCLR that has previously undergone a multi-ligament reconstruction with autografts. Access to allografts, especially ones that can be used for a double bundle technique, is preferable, and augmentation with synthetic tapes has been shown to be beneficial. Any injury missed in the index surgery must be sought and treated as appropriate. An accurate and safe revision PCLR requires the creation of posterior portals for visualization. One must be prepared for various types of graft fixation options, including double fixation in compromised bone. Overall, revision PCLR is a very technically demanding surgery, but the outcomes are generally good.