Complications during cerebral aneurysm embolization continue to occur even at high volume experienced centers. Such situations are unexpected, complex and can have devastating consequences. Individual anecdotal experience offers limited guidance. This literature review of the two most serious neuroendovascular procedural complications-namely, aneurysm perforation and thromboemboli-aims to propose a role based checklist. Having a premeditated plan helps team members remain calm and function more effectively when a procedural complication occurs, with the ultimate goal of minimizing patient harm.