Secondary intraocular lens (IOL) implantation has evolved over the past few decades. Several new techniques, lens options, and materials now exist. Careful patient selection is important to determine the optimal secondary IOL technique. Intraocular lens placement in the capsular bag is the most ideal followed by sulcus placement. However, the best option when no capsular support exists in an aphakic patient remains unclear. Surgeons should be aware of contraindications for each technique; however, there are several situations where anterior chamber intraocular lens (ACIOL), scleral-fixated intraocular lens (SFIOL), and iris fixation can all be used. In those cases, surgeon familiarity and comfort with the secondary IOL technique can determine the type of surgery performed.