Quantum trajectories describe the stochastic evolution of an open quantum system conditioned on continuous monitoring of its output, such as by an ideal photodetector. Here we derive (non-Markovian) quantum trajectories for realistic photodetection, including the effects of efficiency, dead time, bandwidth, electronic noise, and dark counts. We apply our theory to a realistic cavity QED scenario and investigate the impact of such detector imperfections on the conditional evolution of the system state. A practical theory of quantum trajectories with realistic detection will be essential for experimental and technological applications of quantum feedback in many areas.