There is increasing interest in injection lipolysis as a technique for reducing small, localized fat deposits. While many articles have been published about injection lipolysis, none specifically address safety issues. A clinical safety data survey was sent to physicians practicing injection lipolysis. Seventy-five physicians from 17 countries responded. Data from the treatment of 17,376 patients who underwent a total of 56,320 injection sessions were analyzed. Among the topics reviewed in the survey were indications and contraindications for treatment, best and worst areas for treatment, and additives to the formula and their efficacy. Expected sequelae were differentiated from unexpected complications. The safety data collected here indicate that, when practiced by licensed and certified physicians, the safety record for injection lipolysis is excellent. There were no deaths or hospitalizations resulting from treatment. There were also no bacterial or atypical mycobacterial infections, no reports of skin loss or ulceration, and no episodes of dermatitis or chronic skin irritation. Among the 17,376 patients treated, 0.0021% experienced transient hyperpigmentation, 0.015% had persistent pain beyond 2 weeks posttreatment, 0.0003% had a late allergic reaction, and 0.00006% had a contour irregularity requiring additional injection treatment. Disappointment at a less-than-expected aesthetic result was expressed by 12.34% of patients. There was consensus among responding physicians on the need for pretreatment patient education regarding realistic expectations. This survey is a representative, not definitive, survey of treatment results that is intended to serve as a starting point for further development and improvement of injection lipolysis technique.