diff --git a/homeassistant/components/elgato/config_flow.py b/homeassistant/components/elgato/config_flow.py
index e2832554a22..eaaa127c471 100644
--- a/homeassistant/components/elgato/config_flow.py
+++ b/homeassistant/components/elgato/config_flow.py
@@ -71,6 +71,43 @@ class ElgatoFlowHandler(ConfigFlow, domain=DOMAIN):
         """Handle a flow initiated by zeroconf."""
         return self._async_create_entry()
 
+    async def async_step_reconfigure(
+        self, user_input: dict[str, Any] | None = None
+    ) -> ConfigFlowResult:
+        """Handle reconfiguration of an existing Elgato device."""
+        errors: dict[str, str] = {}
+
+        if user_input is not None:
+            elgato = Elgato(
+                host=user_input[CONF_HOST],
+                session=async_get_clientsession(self.hass),
+            )
+
+            try:
+                info = await elgato.info()
+            except ElgatoError:
+                errors["base"] = "cannot_connect"
+            else:
+                await self.async_set_unique_id(info.serial_number)
+                self._abort_if_unique_id_mismatch(reason="different_device")
+                return self.async_update_reload_and_abort(
+                    self._get_reconfigure_entry(),
+                    data_updates={CONF_HOST: user_input[CONF_HOST]},
+                )
+
+        return self.async_show_form(
+            step_id="reconfigure",
+            data_schema=vol.Schema(
+                {
+                    vol.Required(
+                        CONF_HOST,
+                        default=self._get_reconfigure_entry().data[CONF_HOST],
+                    ): str,
+                }
+            ),
+            errors=errors,
+        )
+
     async def async_step_dhcp(
         self, discovery_info: DhcpServiceInfo
     ) -> ConfigFlowResult:
diff --git a/homeassistant/components/elgato/quality_scale.yaml b/homeassistant/components/elgato/quality_scale.yaml
index 4649f4ad134..4bfd143989f 100644
--- a/homeassistant/components/elgato/quality_scale.yaml
+++ b/homeassistant/components/elgato/quality_scale.yaml
@@ -62,7 +62,7 @@ rules:
   entity-translations: done
   exception-translations: done
   icon-translations: done
-  reconfiguration-flow: todo
+  reconfiguration-flow: done
   repair-issues:
     status: exempt
     comment: |
diff --git a/homeassistant/components/elgato/strings.json b/homeassistant/components/elgato/strings.json
index ae8d5abf962..dcfeb23d9ac 100644
--- a/homeassistant/components/elgato/strings.json
+++ b/homeassistant/components/elgato/strings.json
@@ -3,13 +3,23 @@
     "abort": {
       "already_configured": "[%key:common::config_flow::abort::already_configured_device%]",
       "cannot_connect": "[%key:common::config_flow::error::cannot_connect%]",
-      "no_devices_found": "[%key:common::config_flow::abort::no_devices_found%]"
+      "different_device": "The configured Elgato device is not the same as the one at this address.",
+      "no_devices_found": "[%key:common::config_flow::abort::no_devices_found%]",
+      "reconfigure_successful": "[%key:common::config_flow::abort::reconfigure_successful%]"
     },
     "error": {
       "cannot_connect": "[%key:common::config_flow::error::cannot_connect%]"
     },
     "flow_title": "{serial_number}",
     "step": {
+      "reconfigure": {
+        "data": {
+          "host": "[%key:common::config_flow::data::host%]"
+        },
+        "data_description": {
+          "host": "[%key:component::elgato::config::step::user::data_description::host%]"
+        }
+      },
       "user": {
         "data": {
           "host": "[%key:common::config_flow::data::host%]"
diff --git a/tests/components/elgato/test_config_flow.py b/tests/components/elgato/test_config_flow.py
index e3ed2c10818..6f05df22ae5 100644
--- a/tests/components/elgato/test_config_flow.py
+++ b/tests/components/elgato/test_config_flow.py
@@ -3,7 +3,7 @@
 from ipaddress import ip_address
 from unittest.mock import AsyncMock, MagicMock
 
-from elgato import ElgatoConnectionError
+from elgato import ElgatoConnectionError, ElgatoError
 import pytest
 
 from homeassistant.components.elgato.const import DOMAIN
@@ -331,3 +331,76 @@ async def test_dhcp_discovery_no_match(
     assert result["type"] is FlowResultType.ABORT
     assert result["reason"] == "no_devices_found"
     assert mock_config_entry.data[CONF_HOST] == "127.0.0.1"
+
+
+@pytest.mark.usefixtures("mock_elgato")
+async def test_reconfigure_flow(
+    hass: HomeAssistant,
+    mock_config_entry: MockConfigEntry,
+) -> None:
+    """Test reconfiguring an existing Elgato device."""
+    mock_config_entry.add_to_hass(hass)
+
+    result = await mock_config_entry.start_reconfigure_flow(hass)
+    assert result["type"] is FlowResultType.FORM
+    assert result["step_id"] == "reconfigure"
+
+    result = await hass.config_entries.flow.async_configure(
+        result["flow_id"],
+        user_input={CONF_HOST: "127.0.0.42"},
+    )
+
+    assert result["type"] is FlowResultType.ABORT
+    assert result["reason"] == "reconfigure_successful"
+    assert mock_config_entry.data[CONF_HOST] == "127.0.0.42"
+
+
+async def test_reconfigure_flow_cannot_connect(
+    hass: HomeAssistant,
+    mock_elgato: MagicMock,
+    mock_config_entry: MockConfigEntry,
+) -> None:
+    """Test reconfigure flow recovers from a connection error."""
+    mock_config_entry.add_to_hass(hass)
+
+    result = await mock_config_entry.start_reconfigure_flow(hass)
+
+    mock_elgato.info.side_effect = ElgatoError
+    result = await hass.config_entries.flow.async_configure(
+        result["flow_id"],
+        user_input={CONF_HOST: "127.0.0.42"},
+    )
+
+    assert result["type"] is FlowResultType.FORM
+    assert result["step_id"] == "reconfigure"
+    assert result["errors"] == {"base": "cannot_connect"}
+
+    mock_elgato.info.side_effect = None
+    result = await hass.config_entries.flow.async_configure(
+        result["flow_id"],
+        user_input={CONF_HOST: "127.0.0.42"},
+    )
+
+    assert result["type"] is FlowResultType.ABORT
+    assert result["reason"] == "reconfigure_successful"
+
+
+async def test_reconfigure_flow_different_device(
+    hass: HomeAssistant,
+    mock_elgato: MagicMock,
+    mock_config_entry: MockConfigEntry,
+) -> None:
+    """Test reconfigure aborts when the device at the new host has a different serial."""
+    mock_config_entry.add_to_hass(hass)
+
+    result = await mock_config_entry.start_reconfigure_flow(hass)
+
+    mock_elgato.info.return_value.serial_number = "DIFFERENT_SERIAL"
+    result = await hass.config_entries.flow.async_configure(
+        result["flow_id"],
+        user_input={CONF_HOST: "127.0.0.42"},
+    )
+
+    assert result["type"] is FlowResultType.ABORT
+    assert result["reason"] == "different_device"
+    assert mock_config_entry.data[CONF_HOST] == "127.0.0.1"