Gluteoplasty, any surgical procedure designed to modify shape and volume of the buttocks, has gained significant popularity in recent years. Target groups include the massive weight loss -, transgender, and lifestyle patient. This chapter delves into key aspects including anatomical considerations, surgical techniques, and potential complications. A thorough understanding of the buttock anatomy is crucial for preoperative planning, safe and effective surgery. Factors such as the pelvic skeleton, buttocks muscle configuration, skin quality, and fat tissue distribution influence the choice of surgical technique. Various techniques are employed in gluteoplasty, including fat grafting, implant placement, a combination of both or random- and perforator-based flaps. Each technique has its own advantages and potential risks. Careful patient selection and meticulous surgical technique are essential to minimize complications such as bleeding, infection, seroma formation, and fat embolism. Postoperative care including compression garments, pain management, and activity restrictions is key in optimizing healing, outcomes and minimizing complications. Ongoing research and technological advancements aim to further improve the safety and efficacy of gluteoplasty. In conclusion, gluteoplasty is a complex procedure that requires expertise and experience. By considering patient factors, employing appropriate surgical techniques, and adhering to strict safety protocols, surgeons can achieve aesthetically pleasing and long-lasting results.