Complications in vitiligo surgery include those which are specific to the technique and those which are common to any surgery. Some complications are common to any surgery such as reactions to anesthetic agents, infections, keloid formations, etc. Specific complications can occur in the donor as well as the recipient areas are discussed in this chapter. To conclude, with the advancement in the techniques and horizontal spread of training, surgical therapies are more frequently practiced especially in Asian countries. Serious postoperative complications arising from dermatologic surgery are uncommon. Not every patient with vitiligo is a good candidate for surgical repigmentation and the key for success is an appropriate selection of patients, since there are specific criteria that must be fulfilled for vitiligo surgery. Proper patient counseling about the nature of the disease and the surgery, limitations of the procedure and whether more procedures will be needed for optimal outcome should be done. Patient should be counseled for all possible therapeutic options and should be given liberty to choose from the available modalities. Many complications may be prevented by preoperative evaluation, sound surgical technique and careful follow-up care.