This chapter deals with safety and complications, and probe maintenance in transesophageal echocardiography (TEE). TEE is frequently undertaken outside the operating room. The usual sedation offered includes topical anesthesia to the mouth and oropharynx, and one or more intravenous sedatives. Intravenous benzodiazepines have been the mainstay of intravenous sedative techniques over the years, particularly for non-anesthetists, and they are still frequently used. TEE has been described as a semi-invasive procedure, presumably to identify it as less invasive than intravascular monitoring and diagnostic procedures. TEE is a relatively safe procedure that can be undertaken on a wide range of patients and with minimal complications. Close attention to probe care, maintenance, and disinfection also plays an important role in maintaining the effectiveness of each study and of the TEE service, whether in the echo lab or in the operating room.