Iatrogenic complications of thoracic and cardiovascular surgery are relatively uncommon, but contribute to potentially significant patient morbidity and mortality. The incidence of iatrogenic disease reflects the complexity of surgical procedures, including lung resection, esophagectomy, coronary artery bypass grafting, thoracic aorta repair, and cardiac valve replacement. Some iatrogenic complications are minor and common to all procedures, whereas others can be potentially devastating and are associated with precise technical components of specific surgeries. Multimodality imaging plays an important role in the diagnosis and management of operative thoracic and cardiovascular iatrogenic disease.