Many lacerations seen in the emergency department setting require specific management based on anatomic location. Lacerations of the fingertip, ear, nose, lip, tongue, and eyelid can be complex and require advanced management techniques. Many can be primarily treated by emergency clinicians; however, it is important for the clinician to know when consultation is appropriate for treatment by a specialist. Current literature recommendations are presented for initial management, methods of repair, technical tips to facilitate repair, appropriate consultation, and postoperative care for these complex lacerations.