Adverse events occur at relatively high rates perioperatively. Reported adverse events likely underestimate the true rates of occurrence. Reporting of adverse events may occur via automated versus self-reporting mechanisms. A standardized approach should be used to analyze adverse events, which should include a categorization of the event, a harm score, and an evaluation of the contributing factors. Where possible, there should be a focus on systems changes that can prevent future similar adverse events from occurring. Departments affected or involved in the adverse event should also participate in the analysis process. Disclosure to the affected patient(s) and their families is often an integral part of the process. It is important to provide feedback and any follow-up actions for the involved clinician(s), bearing in mind the principles of just culture. Lessons learned and any systems changes should be shared with the entire department not only for educational purposes but also in the spirit of preventing a recurrence. Long-term tracking of adverse events along with resolution is important for trend analyses. Ultimately, safer systems that reduce future adverse events can decrease costs to the healthcare system.