Reservoir placement during inflatable penile prosthesis (IPP) surgery is one of the most challenging aspects of the procedure, mainly due to the proximity of critical structures like the bowel, bladder, and major vasculature. Several techniques for reservoir placement have been developed to improve safety and reduce complications. This chapter reviews both traditional and alternative placement techniques, discussing the advantages and disadvantages of each approach and strategies for minimizing risk and managing complications. Traditional placement in the space of Retzius poses a higher risk of complications in patients with prior pelvic surgery, radiation, or complex anatomy. Innovations, such as alternative placement techniques, low-profile reservoirs, and lockout valves, have improved the procedure’s safety. The risk of complications, including auto inflation, reservoir herniation, and injuries to the bladder, bowel, or vascular structures, can be mitigated with effective prevention and management strategies. Surgeons must be familiar with various techniques to tailor the procedure to individual patients, optimizing outcomes and reducing the risk of complications. This paper provides a comprehensive overview of IPP reservoir placement techniques and highlights new advancements that enhance patient safety in complex surgical scenarios.