Female urethral reconstruction is an uncommon surgery to repair female urethral strictures, diverticulum, and fistulas. Because of the rarity of these operations, complications have not been well described in the literature. Complications can be categorized as intraoperative and postoperative. Postoperative complications can be further divided into general complications common to all pelvic surgery, which will not be discussed here, and those that are specific to urethral reconstruction. Those complications include: (1) early or late postoperative wound complications from the graft or flap harvest site, (2) stricture or fistula recurrence, (3) de novo postoperative incontinence, (4) de novo or recurrent urethral obstruction, and (5) de novo detrusor overactivity.