From here, the attacking wrestler pushes both the opponent's legs backwards with enough strength to force them into a near horizontal position.
The wrestler applies a 3⁄4 facelock and drops down back first while still holding the opponent's head to force them to fall into the cutter.
Diamond Dallas Page used this version against Billy Kidman in an August 16th, 1999 episode of Nitro.
In this version, a wrestler dives from the top rope and nails a cutter to a standing opponent from the front.
There is also a springboard version in which the wrestler dives from the ropes in a backflip position and delivers a cutter to the standing opponent.
The wrestler then falls backwards so that the opponent is forced to dive forward onto the top of their head due to the angle at which they are dropped.
It is another elevated cutter variation in which the opponent is first raised over the shoulders of a wrestler in the fireman's carry position.
WWE wrestler Charlotte Flair uses this move as her finisher, calling it Natural Selection.
The wrestler then pivots 180° and catches the opponent in a 3⁄4 facelock with their free arm before falling down into the cutter.
This variation sees the attacking wrestler execute an inverted suplex lift on the opponent before bringing them down face first with the cutter.
Karl Anderson and Tama Tonga also use this variation, calling it the Gun Stun and Matt Riddle has used the RKO since he started teaming with Randy Orton.
It is common for the wrestler to not properly apply the 3⁄4 facelock and the move to end up more in a DDT position.
The move was innovated by Susumu Yokosuka and has since been used by several other wrestlers like Bobby Lashley and Buddy Matthews.
Damian Priest used this move as his finisher, calling it The Reckoning, prior to Rhodes returning to WWE in 2022.
A modified version which involves hoisting the opponent off their feet before beginning the spin has also been used by other wrestlers.
The second major variation, which is known as an outward rolling cutter and referred to as a Whirling Dervish in Japan, sees the wrestler spin in the opposite direction while holding onto the opponent's free arm while twisting for leverage.
Another variation sees the wrestler roll forward before leaping to hit the opponent with a cutter.