Neurovascular complications are important complications during total knee arthroplasty, which may result in serious morbidity, amputation or even mortality. Vascular complications are generally observed in direct vascular injury, pseudo aneurysm and arterio-venous fistula formation. Early diagnosis and treatment are critical after vascular complications. Unfortunately, the diagnosis and treatment results of 4–6 hours are seen as irreversible muscle and nerve complications. However, mortality and limb loss are rarely observed. Neurological complications include peripheral nerve lesions that are not only associated with the surgeon and surgery. Generally, low incidence of nerve complications is increasing with increasing number of cases of arthroplasty nowadays. Perioperative nerve injuries are one of the most important complications affecting patient`s quality of life. The predisposing factors for nerve injuries that may occur during knee arthroplasty are knee flexion contracture, advanced valgus deformity, regional anesthesia, tourniquet use, and development of an intra-knee hematoma. However, these factors could not be directly correlated with nerve damage. Neurovascular complications are the most important complications that are rarely observed. However, it is more frequent due to increased number of total knee arthroplasty operations.