While geriatric patients do not present problems of positioning that are found only in their age group, their acquired infirmities may intensify the likelihood and severity of complications common to younger peers. Careful preoperative evaluation of potential positioning problems is needed, as is explicit recording of positioning recommendations in a manner easily encountered by appropriate members of the care team. The physiologic impact of those infirmities that are present upon the ability of the patient to recover from the surgical and anesthetic experience should be kept clearly in mind throughout the procedure, and techniques involved should be modified accordingly. A postoperative survey of potential complications of positioning should be made expeditiously to permit indicated treatment to be applied rapidly to an elderly patient.