Temporal lobe resection procedures for drug-resistant temporal lobe epilepsy are safely and widely performed with low mortality and morbidity rates. However, the occurrence of a neurological complication associated with epilepsy surgery becomes more dramatic compared to other neurosurgical procedures because the vast majority of surgical candidates are neurologically intact. Therefore, it is extremely important to know the potential complications, prevent them if possible, or manage them appropriately when they occur. Additionally, understanding the mechanisms of these complications is necessary to utilize neuroimaging, neurophysiological, or surgical techniques that can prevent their development. Proper orientation for reaching the temporal horn of the lateral ventricle, adequate and accurate imaging of the mesial temporal structures, and avoiding damage to the anterior choroidal artery and Meyer's loop are essential. Finally, meticulous dissection techniques and the accurate separation of hippocampal nutrient arteries during hippocampal resection should minimize the risk to the main artery. Appropriate patient selection, along with the correct surgical approach, as well as the surgeon's knowledge of neuroanatomy and experience, are key to successful surgery. This article aims to provide an overview of complications in temporal lobe surgery and methods for preventing these complications.