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Laparoscopy is routinely performed for the treatment and management of gynaecologic disorders. During gynaecologic laparoscopy, the patient is placed in the Trendelenburg position to optimize visualization and access to the pelvis. The Trendelenburg position may result in complications in many organ systems.Trendelenburg positioning may cause rare, potentially life-threatening complications of the respiratory and cardiovascular systems. Case reports of visual field loss and cognitive aberrations following Trendelenburg positioning have been published. Few intervention studies have been performed evaluating attenuation of changes in intraocular pressure and haemodynamics.This review summarizes possible complications related to the Trendelenburg position and current evidence regarding interventions to minimize the risk of complications.