The authors present a comprehensive and critical discussion of radio frequency technology with detailed descriptions of unipolar, monopolar, bipolar, multipolar as well as fractionated microneedling technologies, supported by some examples of current devices. Critical discussion is provided concerning the literature underpinning the biological effects for skin tightening with consideration to the level of power used, with insightful diagrams to provide visual representation of some of the advantages and disadvantages of using low and high power radio frequency, concerning clinical outcome and other key parameters. Contraindications and cautions are clearly outlined, along with side-effects with guidance provided on costing variables and business planning. This is an interesting overview and introduction for aesthetic clinicians considering utilising radio frequency into their practice. The addition of the author’s own before and after clinical photographs of an abdominal radio frequency procedure provide clarity to the reader.