Complications of gynecologic laparoscopy are uncommon, occurring in 3 to 6 per 1000 cases. Complications related to access represent one-third to one-half of these injuries. Major operative complications are more likely to occur in complex procedures. Through the comprehensive understanding of the relevant anatomy, surgical instruments, complex maneuvers, and optimal surgical technique, gynecologic laparoscopists can avoid most of the complications described. Even in the best of hands, however, complications will occur. Most importantly, surgeons should be diligent in recognizing and managing these events.