The use of acute mechanical circulatory support (AMCS) devices is growing. Applications include cardiogenic shock and high-risk coronary, valvular, and electrophysiologic interventions. While most reports in this field focus on hemodynamic effects, myocardial recovery, and end-organ function, one of the most important determinants of clinical outcomes is associated with adverse vascular events (AVEs). AVEs can be broadly categorized into four phases: at the time of insertion, while on mechanical support, at the time of device removal, or after device removal. Each of these AVEs is also unique to the type of AMCS being employed.