In parallel to recent advances in laser technology, safety and efficacy of corneal refractive surgery have been significantly improved. For instance, flap-related complications of laser in situ keratomileusis (LASIK) have been significantly decreased, whereas new technologies also brought together their unique intraoperative and postoperative disadvantages. Fortunately, most of the vision-threatening complications of laser refractive surgery can be minimized by a well-trained and educated refractive surgeon. This chapter highlights the etiology, prevention, and management of intraoperative complications of LASIK and small incision lenticule extraction (SMILE) in a systematic manner based on the recent evidence. © Springer Nature Switzerland AG 2022.