Vascular complications such as hematoma, pseudoaneurysm, and arteriovenous fistula that occur after intracoronary or intracardiac procedures are responsible for considerable morbidity and some mortality. In addition, many of these complications result in considerable increases in hospital stays and in the costs associated with the procedures. A number of risk factors for vascular complications after coronary interventions have been identified. They include excessive anticoagulation, use of femoral sheaths for extended lengths of time, multiple interventions during the same hospitalization, catheter insertion in the superficial or deep femoral artery larger catheter size, and complex interventions such as stent deployment or atherectomy. Specific interventions have been identified that help to decrease procedural risk, improve early detection and prompt treatment of the vascular injury, and prevent long-term disability.