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Because of safety and minimally invasion, hysteroscopic surgery has gotten popularity and has become the routine for diagnostic and therapeutic interventions of intrauterine pathology. Advantages consist of short operating time, rapid postoperative recovery and low morbidity. However, during hysteroscopic surgery there are concerns about potential complications such as venous air and gas embolism. These are rare but hazardous complications, which can occur in all surgical procedures. In hysteroscopic surgery, large uterine veins may be exposed and are, therefore, entries for gas or air. A number of fatal cases have been described as case reports. Although awareness for air and gas embolism is raised this way, proper guidelines how to reduce the risk of venous gas or air embolism are lacking. The pathophysiologic difference between gas and air embolism is described herein because composition of the gases differs with their different physiologic effects. Signs and symptoms of patients are described, as early detection and intervention are crucial for survival. Furthermore, we provide guidelines for operating department personnel, surgeons, and anesthesiologists to reduce the risk of venous gas or air embolism during hysteroscopic procedures. Potential complications of these procedures may be prevented by this way. [ABSTRACT FROM AUTHOR]