The user first attaches strings beforehand onto the tossed shuriken and the kunai thrown after it, then one shuriken is pulled back using a tree as an axis, based on the yo-yo's principle. The other shuriken and kunai are decoys, and the true attack is the shuriken that is pulled back using the force of the thrown kunai. The trick in making this technique successful is to somehow be able to read the enemy's movements, which normally would require the Sharingan.
In the manga, when using this technique against Orochimaru, Sasuke infused the kunai he threw with what appeared to be chakra.
When fighting against a disguised Orochimaru, Sasuke combined this technique with the Dragon Fire Technique, sending the fire down a metal string in order to burn his opponent.