Abstract: A body immobilization and support device including a generally rigid shell having a back portion which is generally contoured to the back of a patient, and having side engaging portions and shoulder engaging portions to immobilize and support the patient during surgery. The device further includes fasteners to fasten the shell to an operating table and prevent sliding when used in an extreme head down position. The device may include a cushioning pad along the inside of the shell in order to increase patient comfort.