Operative hysteroscopy is a minimally invasive gynaecological procedure and is considered the gold standard for the treatment of intracavitary uterine pathology. Over the last decades, with the development of new surgical instruments, the popularity of this technique has increased with gynaecologists across the world. However, this minimally invasive technique can be associated with rare but serious complications that can lead to severe morbidity and, if not treated adequately in some cases, ultimately lead to mortality. Any gynaecologist using this procedure should not only train in the operative technique but should also acquire knowledge on what type of complications may arise whilst performing an operative hysteroscopy. The following chapter explores the diagnosis of complications associated with the operative hysteroscopy and management options.