Conduction system pacing, particularly left bundle branch area pacing (LBBAP), has become a popular form of lead implantation for patients with ventricular pacing indications. Success rates are reportedly high, and complication rates are relatively low. However, complications with LBBAP are unique and follow-up and troubleshooting need to be more meticulous. This paper reviews some of the short- and longer-term complications that one may see with LBBAP. Guidance on device programming, follow-up and tips on troubleshooting for LBBAP is also provided.