Nasal obstruction from a deviated septum is one of the more frequent complaints bringing patients into an otolaryngology office. Despite the significant number of septoplasties performed each year, complications after this procedure are relatively uncommon. Most complications result from inadequate surgical planning or poor technique and often can be prevented. Surgeons should discuss these risks with patients before surgery as part of the informed consent process. This article reviews how complications of septoplasty can occur, compromising the functional and aesthetic aspects of a patient's life, and how attention to detail can reduce the risk for these complications. The septoplasty surgeon must be aware of all the possible complications that may arise so as to convey the benefits and risks of surgery effectively to prospective patients.