Skull Base surgical complications can be devastating for both the patient and the surgeon. Otolaryngologists may encounter complications during ear and sinus surgery. The purpose of this panel presentation is to offer practical and actionable advice to general otolaryngologists on how to avoid and how to manage common major surgical complications. This unique panel will be composed of anterior and lateral skull base surgeons. The panelists will share their approach to critical evaluation of preoperative imaging and to dealing with iatrogenic complications of the anterior skull base, facial nerve, sigmoid sinus, and tegmen. Case presentations will be used to illustrate the utility of pre-operative imaging in detecting challenging anatomy that may alter the surgical approach, the importance of sound surgical technique to help prevent complications, and the decision-making process when complications do occur.