By keeping in mind the principle of stability, ease of exposure and physiologic restrains on the patient, the optimum safe positioning technique for successful spinal surgery can be selected. We recommend skeletal or head-halter traction for anterior exposure of the cervical spine. Gardner's three-point skeletal fixation or halothoracic immobilization are the methods of choice for posterior cervical spine exposure. Either rolled towels or the Relton-Hall frame are preferred for posterior thoracolumbar surgery. Specific attention to protection of the eyes, bony prominences and peripheral nerves is essential.