Complications are an inherent part of our practice of medicine, especially with surgical specialties. Neurosurgery is the most intricate of all, and complications in this field can be truly devastating, and may not only make the patient and his/her family miserable but also tarnish the name of the neurosurgeon and the specialty at large. There are two sides of the coin of Complications – Anticipation or Prevention, and Recognition and Management. In our increasingly litigious society, it is best to make every effort to prevent them from occurring by careful attention to patient’s history and clinical examination (before jumping to the images), accurate reading of scans and other investigations, and discussing the nuances of the case, preparing detailed plan and alternatives towards its approach, execution and closure (or repair), with members of the neurosurgical and allied specialty teams. Involving the patient and his/her family in decision-making, making them allies of our plan and patient-care will lessen the ill-feeling and agitation that can possibly arise following a complication. Intra-op management of complication is often complex, and if well-planned, intra-op adverse events can be handled swiftly, and with least fuss or agony between the surgeon and his team; but in the face of unexpected events, much will depend upon the experience and wisdom of the surgeon. between the surgeon and his team; but in the face of unexpected events, much will depend upon the experience and wisdom of the surgeon. Again, it is necessary and prudent to convey such events to the patient’s family as soon as one can.