Every year, the Society of Obstetric Anesthesia and Perinatology nominates 1 individual to survey the prior year's literature and to identify the most notable articles for the science and practice of obstetric anesthesiology. This article reviews the 2009 literature, focusing on the theme of maternal patient safety, and advancing the notion of the obstetric anesthesiologist as both a perioperative and a peripartum physician. Three specific topics are reviewed: complications of obstetric anesthesia, general obstetric complications, and quality and safety in peripartum care.