An extravasation is the unintentional leakage of an intravenously-administered drug into the surrounding tissue. Extravasation can cause serious tissue injury. Risk factors for tissue injury can be divided in patient-related factors (age, site of extravasation, comorbidities, physical condition of the patient) and drug-related factors (mechanical injury, pharmacological properties, physicochemical properties). If the right treatment strategy (expectative policy, pharmacological or surgical intervention) is chosen at an early stage, tissue injury can largely be avoided. Comprehensive multidisciplinary approach and communication between nursing staff, the treating physician, the plastic surgeon and the hospital pharmacist is mandatory for the treatment of a patient with extravasation.