Correct positioning of patients undergoing an MRM is vitally important. Patients should be in a supine position with the side of the MRM close to the edge of the operating table. The endotracheal tube should be positioned toward the contralateral side of the mouth from the side of the MRM. Arms should not be abducted greater than 90 degrees to prevent injury to the brachial plexus. Arms should be placed on padded arm boards and positioned in a way that pressure points are alleviated. It is often helpful, particularly with bulky adenopathy, to prepare the ipsilateral arm into the field and wrap it with a sterile stockinette and Kerlix wrap (FIG 4). This allows for relaxation of the pectoralis muscles and easier access to the level II and III axillary nodes.