As the number of total hip arthroplasty (THA) procedures performed each year continues to rise and patients continue to live longer, the incidence of revision THA is expected to increase. Of the three main approaches (posterior, lateral, and anterior), the posterior approach, which also is known as the posterolateral or the Southern Moore approach, remains the most common surgical approach for primary and revision THA. This approach offers maximum utility, allowing for extension distolaterally to the entire femur and proximal-posteriorly to the entire acetabulum and ilium. The incidence of intraoperative complications, such as periprosthetic fracture and nerve injury, are higher in revision THA than in primary THA. In difficult revision procedures that involve scar tissue, limb shortening, and bone loss, the first and most crucial step of the procedure is reproducibly performing an extensile approach to safely explant and subsequently replant THA components. Additional muscle releases may include the gluteal sling, medial intermuscular septum, and adductor tendons distally. This video reviews a stepwise approach to efficiently and safely perform extensile revision posterior THA.