Spinal injections are frequently performed for the relief of pain. These injections include both interlaminar and transforaminal approaches to the epidural space, spinal injections, and paravertebral injections. Frequently steroids are used, but neurolytic procedures may be performed as well. These injections have a good safety record, but a thorough understanding of the possible complications will improve patient safety even further. The goal of this article is to discuss these complications, including infections, hematomas, compromise of the vascular supply to the spinal cord, and reactions to contrast or corticosteroids.