Cervical total disc replacement (CTDR) has gained popularity over the last 2 decades. It is a motion-preserving option to ACDF and is becoming more popular with patients and surgeons alike. Understanding complications that are unique to CTDR is crucial to performing successful, durable surgery. Careful patient selection and meticulous surgical technique are key to reducing complications associated with the surgery. Patient’s should be followed closely after surgery with routine flexion/extension x-rays for early detection of any complications that may occur. Most complications can be observed with close follow-up. However, it is incumbent on the surgeon to recognize when revision surgery is necessary.