Abstract As total hip arthroplasty rates continue to increase worldwide, so too does the prevalence of periprosthetic femur fractures. To properly manage these often-complex fractures, orthopaedic surgeons must have a systematic method for evaluating the patient as well as the fracture pattern. This review examines the demographic- and implant-specific factors that predispose patients to periprosthetic fractures with the goal of mitigating the risk of occurrence and improving patient counseling. Furthermore, with the development of new techniques and modern implants for the management of periprosthetic femur fractures, more tools are now available to address these complications and optimize patient outcomes.