The three-piece inflatable penile prosthesis (IPP) is an effective, safe treatment for medically refractory erectile dysfunction (ED), consisting of two corporal cylinders, a scrotal pump, and a reservoir. Reservoir placement (RP) is often considered the most complex step in IPP implantation, and its possible complications can have serious consequences. Despite these difficulties, advancements in both technology and surgical methods over the past 20 years have both increased the efficacy and reduced the risks of IPP RP. Overall, when approaching RP and its associated adverse events, a thorough knowledge of relevant anatomy and technique-specific complication profiles is necessary for complication prevention, identification, and management.