Despite the good midterm survivorship reported for unicondylar knee arthroplasty, an increase in revision surgery has to be expected due to increased replacement rates. The reasons for failure as well as distribution are different for unicondylar knee arthroplasty compared to total knee arthroplasty. The main reasons for revision are aseptic loosening and the progression of osteoarthritis. In most cases, unicondylar knee arthroplasty will be revised to total knee arthroplasty. To obtain good revision results, the cause of implant failure has to be analysed carefully. In the case of contained bone defects, the reconstruction can be supported with bone grafting. For those cases with uncontained defects, implants with augmentation and, in some cases, stem extensions are needed. The modularity of the revision implant should cover different intraoperative requirements.