A lot can go wrong when patients are placed in steep Trendelenburg. This high-risk position has many well-known dangers, such as shearing injuries that occur when patients slide down the surface of the table, as well as many lesser-known risks, such as detached retinas or postoperative blindness caused by increased intraocular pressure. When placing patients in the head-down position, implement whatever measures are necessary to protect them from harm. Fortunately, there are several straightforward steps you can take to reduce the risks of injuries and complications.