Abstract: An adjustable limb support system is provided for an operating room table to adjustably orient and position a stirrup or boot. The support system provides an adjustable support in combination with a vertically adjustable support. The vertically adjustable support includes a support arm, a ratchet wheel, a lock pin, and a ratchet release. The support arm is connected to a housing which both rotate about the ratchet wheel in a rotational plane extending upwardly and outwardly from the operating room table for automatic abduction. The lock pin engages the ratchet wheel and allows the support arm to be rotated upwardly but not downwardly. The ratchet release disengages the lock pin and allows the support to be rotated downwardly. The support arm can thus ratchet upwardly to fixed vertical positions and be lowered only by disengaging the lock pin. The adjustable support includes a retaining block, a compression block, and a compression head.