Complications in orthognathic surgery may stem from occurrences at anyone of many time points during the course of the patient's treatment: preoperative judgment and planning, perioperative orthodontic care, or intraoperatively. This article specifically addresses those complications that arise as a result of intraoperative technique. Such complications may broadly be characterized as airway, vascular, neurologic, infectious, skeletal, or aesthetic in nature. For each type, specific complications, their prevention, and their treatment are discussed.