Twelve music therapists working in a range of settings throughout the United States were interviewed and asked to recall harmful events they experienced during music therapy sessions. In total, 61 harmful or potentially harmful events were described and subsequently analyzed using procedures consistent with qualitative content analysis. Four categories emerged that characterized these harmful events: (1) emotional harm, (2) physiological harm, (3) physical harm, and (4) relationship harm. Within each of these categories, therapist self-awareness, clinical decision-making, and clinical competence are discussed. The findings suggest a need for increased awareness of the potential for harm in music therapy clinical practice, increased education for students and new professionals entering clinical training/practice, as well as additional research exploring the ways music therapists may define, navigate, and prevent harm.