Operative hysteroscopy has emerged as the state-of-the-art therapeutic modality for treating intrauterine polyps, submucous myomata, synechia, uterine septa, and dysfunctional uterine bleeding. As a growing number of physicians endeavor to perform more advanced hysteroscopic surgeries, the significance of complications rises. This article discusses the prevention, detection, and management of seven common or dangerous complications: distention-media-related problems, mechanical accidents, bleeding, anesthetic complications, laser and electrical injury, infection, and air embolism.