The absolute number of periprosthetic fractures seen by the orthopaedic surgeon is increasing. The basic principles of fracture management include preoperative patient optimization and determining the stability of the associated components. Loose components require revision, whereas fractures associated with well-fixed implants are generally treated with internal fixation. Although these fractures are challenging to manage, advances in surgical techniques, including the use of locking plates for internal fixation and improved revision systems and biomaterials (such as highly porous metals), offer the surgeon enhanced tools for treating these complex clinical disorders.