Hepatic artery infusion pump chemotherapy is used to treat colorectal liver metastases, intrahepatic cholangiocarcinoma, and other intrahepatic malignancies. Placement of the pump involves insertion of a catheter in the gastroduodenal artery, as well creation of a subcutaneous pocket to house the pump itself. Contemporary studies show an overall complication rate of approximately 25% (Bacchetti et al., Med Devices (Auckl) 2:31–40, 2009). Complications range from issues with the pocket, such as infection, hematoma, seroma, and erosion, catheter complications such as erosion into viscera or thrombosis, vascular complications such as pseudoaneurysm and dissection, and biliary complications such as sclerosis. Some HAI complications can be managed conservatively, allowing for ongoing pump use. Some may be managed by rescue procedures utilizing a multidisciplinary team. Some complications, as well as termination of therapy and patient preference, necessitate pump explantation. Surgeons who place these pumps must be familiar with the management of such complications, as well as the indications and technique for removal.