Stent delivery systems and methods for making and using stent delivery systems are disclosed. An example stent delivery system may include an inner member having a stent receiving region. A stent may be disposed along the stent receiving region. The system may also include a deployment sheath axially slidable relative to the inner member. The deployment sheath may have a proximal end region. A rack may be coupled to the proximal end region of the deployment sheath. An outer shaft may be disposed along at least a portion of the deployment sheath. The deployment sheath may be rotatable relative to the inner member, the outer shaft or both.