The achievable image sharpness of a ground-based telescope is normally limited by the effect of atmospheric turbulence. However, with Adaptive Optics (AO) techniques, this major drawback can be overcome so that the telescope produces images that are as sharp as theoretically possible, i.e., as if they were taken from space. 
The intention of this document is summarize in few pages some highlights related with the activities needed to keep MACAO units in operation. Some statistics of problems based in Action Remedy tool is included, showing how through these years the number of problems has been reduced, even when there are still some unsolved ones. Some lessons have been learned and there are others one to learn. Corrective and predictive maintenance performed are shown too like the current measurements, transfer functions measurements, thermography pictures, health checks measuring interaction matrix and flat vectors to detect dead APDs or short circuits in the DM, etc. Some forced interventions are included as well like the removal of the cabinets from Coude rooms to avoid that acoustic noise and vibrations perturb the operations, the deformable mirrors reached by cooling leaks and a mirror that got rusty are shown too.
Well knowledge of the system, good interaction between different disciplines groups to perform corrective and preventive maintenance seems to be key aspects of keeping it under control and operative during all these years leading to this good result.