Vertebral augmentation techniques are minimally invasive procedures widely used in the treatment of osteoporotic vertebral compression fractures and vertebral tumors. They are performed to reduce pain, restore vertebral stability, and improve patients` quality of life. However, these techniques carry various risks of complications. The most frequently encountered complication is cement leakage, which can spread to the paravertebral region, venous system, spinal canal, or intervertebral foramen, potentially leading to severe neurological or vascular issues. New vertebral fractures are associated with factors such as low bone mineral density and excessive cement usage. Although infection is rare after vertebroplasty and kyphoplasty, it can result in serious conditions such as osteomyelitis and epidural abscess. Additionally, rare but potentially life-threatening complications, including dural tears, spinal hematomas, pulmonary embolism, and vascular cement embolism, have been reported. To prevent these complications, patient selection, proper surgical technique, and careful postoperative monitoring are of critical importance.