We describe a technique that uses the Vac Pac (Olympic Medical, Seattle, WA) for patient positioning in shoulder surgery. This technique is well-liked by anesthesiologists, nurses, and operating room staff because of its ease and simplicity. If careful attention is given to detail during positioning, problems with encroachment on the operative field can be avoided. We believe this technique allows for safe and effective patient positioning for shoulder surgery using the readily available and inexpensive Vac Pac.