Early and late complications of liver transplantation continue to be a major source of morbidity and mortality. Complications that occur in the donor can have long-term ramifications for the recipient. Meticulous operative technique is mandatory during procurement and the recipient operation to ensure the best possible outcome. Despite this, difficulties with perioperative management can be related to technical errors, ischemic injury to the graft, biliary strictures, cardiopulmonary events, infections, complications, and recurrent diseases. A favorable outcome after liver transplantation requires technical acumen, sound judgment, and attention to detail.