Iatrogenic scalp lesions represent any lesions inadvertently created as a result of a direct or indirect action of the clinician or surgeon in an attempt to treat an underlying pathology or deformity. The source of these lesions can be from damage directly to the tissue during a procedure or due to the resultant effects from therapies intended to act distantly from the lesion. Iatrogenic scalp injuries can be caused by poorly planned skin incisions, defective or misused cranial fixation devices, radiation injury to the tissue, and chemotherapy impairing normal wound healing, to note some examples. The management for scalp lesions can range from simple observation and with supportive care all the way to placement of rotational free flaps or healing by secondary intention. The consideration of potential iatrogenic injuries should be performed by the clinician or surgeon to avoid these complications as they can lead to poor cosmesis or infection which can complicate the chosen treatment plan for local or systemic pathology. In addition, the emotional impact of the disfigurement can lead to the loss in confidence in the practitioner that results in damage to the relationship with the provider that may prevent the adherence to necessary therapies and a sense of general mistrust for future recommendations. Additionally, the risks of these complications must be anticipated and discussed with the patient to avoid potential medicolegal sequelae.