This chapter provides an overview of the contemporary dissection and re-entry techniques for chronic total occlusion (CTO) revascularization. CTOs develop after thrombotic occlusion and subsequent deposition of calcium, proteoglycan, and collagen. Contemporary dissection and re-entry techniques involve blunt dissection in the extraplaque space to circumvent resistant and long CTO segments. Although several crossing strategies exist, they are complementary and often multiple techniques are needed for successful CTO percutaneous coronary intervention. Contemporary antegrade dissection and re-entry (ADR) is useful to cross long calcified or tortuous CTO segments safely using blunt dissection through the extraplaque space followed by targeted distal vessel re-entry. Starting a proximal dissection can often be difficult, especially in the setting of an ambiguous or impenetrable proximal cap. Antegrade re-entry techniques can broadly be categorized into wire-based or device-based techniques. Novel dedicated ADR devices are on the horizon to help overcome some of the major challenges of ADR technique.