Palliative operations for neonates, infants, and children are performed in anticipation of a “complete repair” in the future. For example, pulmonary artery bands are placed to protect the pulmonary bed for a future operation or for left ventricular (LV) training in anticipation of an arterial switch operation. Systemic-to-pulmonary artery shunts are placed for cyanosis or as the sole source of pulmonary artery perfusion in anticipation of further reparative operations when anatomic and physiologic conditions are more favorable. Bidirectional Glenn shunts are placed as an interim physiologic operation en route to a Fontan operation. Complications associated with these procedures can be life-threatening and prohibitive for complete repair. For instance, a suboptimal and poorly performed systemic-to-pulmonary artery shunt can prevent a future operation such as tetralogy repair or completion Fontan procedure. Further, a poorly placed pulmonary artery band can lead to unwanted pulmonary hypertension, pulmonary artery stenosis, and pulmonary valve distortion. In this chapter we will review complications that can occur in palliative operations and offer suggestions and techniques that can rectify these missteps.