An evidence-based and team-based approach for positioning is needed to ensure a safe surgery. Serious patient injuries can occur if a surgical patient is not correctly positioned, including permanent damage to nerves. Evidence-based guidance from AORN and other safety sources outlines specific safe positioning recommendations for all surgical positions, including high-risk positions such as steep Trendelenburg. Using the correct positioning device(s) is also essential to provide safe patient positioning and this must be done in accordance with the manufacturer’s instructions for use. Advanced planning provides teams with the time and coordination to develop a plan for patient positioning that not only ensures patient safety but also optimizes workflow, device selection/availability and staff time.