Iatrogenic injury is always an unwelcome event at the time of surgery. Prior history of multiple laparatomies, radiation therapy, or a distorted pelvic anatomy caused by a malignancy are all factors that may make iatrogenic injury a likely event. In these situations, complications at times can be considered unavoidable. Injuries during benign surgical procedures also can be difficult to manage, especially if not diagnosed at the time of occurrence. Operative knowledge to manage the more commonly encountered complications must be in the repertoire of all surgeons, including those dealing with abdominopelvic malignancies. This article reviews the more common genitourinary, gastrointestinal, and neural injuries encountered during gynecological surgical procedures and discusses basic management strategies.