Meningomyelocele surgeries are common in pediatric anesthesia and forms a congenital neural tube defect (herniation of meninges and neural elements through a skull defect). One of the main problems which occur during induction of these children is the difficulty in positioning for airway management and the need to prevent sac compression or rupture. We hereby describe a novel way of positioning of these children over an elevated platform, with the occipital meningomyelocele resting in the padded hollow of an adult soft silicon
head rest (used during prone positioning surgeries). After successful induction and airway securing over this, the same elevated platform was used for the definitive surgical procedure. This innovative positioning adjunct not only supports the herniated sac in supine position, but also eases the intubation process in these difficult airway cases and obviates the risk of latex allergy.