The aim of optimal positioning for surgery is to provide the best surgicalaccess while minimizing potential risk to the patient. Each position carries somedegree of risk and this is magnified in the anaesthetized patient who cannotmake others aware of compromised positions.Commonly adopted positions include supine, lithotomy, lateral, seated andprone. Many of these are modified with the addition of a vertical tilt(Trendelenburg or reverse Trendelenburg). This article addresses the generalcomplications associated with positioning as well as the position-specificphysiological changes and complications.