The sitting position is considered as a gold standard for posterior fossa surgical procedures. However, in order to decrease the incidence rate of cerebral venous air embolisms, we presently described a modified supine position allowing performance of posterior fossa surgical procedures. Such position is easy and quickly performed with light variations of blood pressure: patients are placed supine with paddings inserted under ipsilateral shoulder and buttock, and head turned to other side of surgical site. Dural tension estimated by the surgeon was always considered as good. We performed more than 100 surgical procedures in this position without any complication for 10 years.