Abstract: A support pillow providing head and neck support to a user laying upon it. The device employs a support pillow insert surrounded by a pillow casing having planar top and bottom surfaces and a sidewall extending between them. An insert engage able in the casing provides substantially planar support surfaces with a centrally located passage providing a relief for positioning one's head on the pillow. Proper support and spine alignment is provided by a shoulder portion of the pillow for the neck which may be formed of different material than the pillow, or varied in with or compressive force using inserts.