We evaluated a consecutive series of patients followed at least 1 year after revision total knee arthroplasty. We surveyed patients treated at three referral centers over 5 years. An experienced medical interviewer contacted patients and rated their degree of satisfaction with the original and revision arthroplasties, the reason for the original arthroplasty failure, and their expectations for revision arthroplasty longevity. Surveys were completed on 238 of the 408 patients (58%). All patients' operative reports, clinical records, and radiographs were reviewed to determine the diagnosis at revision, procedure performed, and the most likely cause of failure. Patient satisfaction with the primary procedure directly related to the time to revision. The majority (74%) of patients expected their revision to last longer than their primary arthroplasty regardless of revision diagnosis or how long the primary procedure lasted before revision. The surgeons' failure assessments agreed with the patients' failure assessments only 34% of the time. Although the majority of patients (69%) were satisfied with the results of the revision procedure, most did not agree with their surgeon as to why the original arthroplasty failed, and most had unrealistic expectations regarding revision longevity. Level of Evidence: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.