The internal jugular vein (IJV) has traditionally been the just an option site of choice for intraoperative central venous catheterization because of the relatively low risk of serious mechanical complications, such as pneumothorax and hemothorax. However, studies have indicated that subclavian vein (SV) catheterization is associated with lower risk of catheter-related infection (CRI) than IJV catheterization. This complication can be a major concern in orthotopic liver transplantation (OLT). The aim of this study was to compare incidence rates of mechanical and infectious complications associated with intraoperative central venous catheterization via the IJV versus the SV in patients undergoing OLT. Data for 45 consecutive patients who underwent OLT between January 2000 and June 2004 were reviewed, and subjects were divided into two groups according to the site of central venous catheterization (IJV vs SV). Each patient’s physical characteristics, international normalized ratio (INR), partial thromboplastin time, and platelet levels at the time of catheterization were recorded. The data collected with respect to central venous catheterization and its complications included site of insertion, number of puncture attempts, success/failure of central venous catheterization, duration of catheter placement, and occurrence of catheter tip misplacement, arterial puncture, hematoma, pneumothorax, CRI, or bacterial colonization of the catheter. Senior staff anesthesiologists performed 22 SV and 23 IJV catheterizations in the 45 OLT procedures. The groups’ demographic data and coagulation profiles were similar. The SV and IVJ groups both had minor coagulation abnormalities (mild thrombocytopenia; group means 119,000±102,000/mm3 and 93,000±109,000/mm3, respectively) and slightly increased INR values (2.1±1.5 and 1.9±0.7, respectively) at the time of catheterization. There were no significant differences between the groups with respect to success of central venous catheterization (100% for both), numbers of punctures attempted, duration of catheter placement, and incidence rates of mechanical and infectious complications. Both groups had high frequencies of catheter tip misplacement (68% and 78% in groups SV and IJV, respectively), and the site of misplacement was the right atrium in all cases. Two patients in the IJV group (8.7%) developed hematoma after accidental carotid artery puncture. The results suggest that, when performed by experienced anesthesiologists, central venous catheterization via the SV is an acceptable alternative to IJV catheterization in patients undergoing OLT.