Recently, invasive aesthetic procedures such as liposuction is becoming more and more popular in Taiwan. During the past years, we have seen a few patients with acute onset of dyspnea or shock short after liposuction. Liposuction is not routinely practiced in hospitals and medical practitioners may not be familiar to the procedure and its complications. Our hospital is in central Taipei City where the cosmetic clinics cluster. When major complications occur in these clinics, we are very likely to be the first responders. Therefore, it is necessary for us to have some basic understandings of procedure. The goal of this article is to briefly review and discuss the fatal complications of liposuction during perioperative period.