Surgical outcomes are more or less predictable with a reasonable degree of accuracy. Head and neck surgery has potential for many complications due to presence of a large number of major vessels and nerves. In head and neck surgery, complications can arise due to airway compromise, vascular injury, infections and rarely physiologic causes. Carefully performed surgery is the cornerstone of success. Step by step approach with attention to details and a thorough check after completion of the procedure will ensure optimal results without complications.