Patient position in spine surgery is critical for optimal operating conditions and exposure to the surgical site. During spine surgery, the patient is placed in positions that are not physiologically appropriate and can lead to complications. Perioperative peripheral nerve injury (PPNI) and postoperative vision loss (POVL) are rare complications related to patient posture during spinal surgery leading to disability and loss of function. Significant for the patient. INPP is usually caused by a stretched or pinched peripheral nerve. INPP can present as brachial plexus injury or as an isolated injury to a nerve, most commonly as ulnar nerve. Understanding the etiology, mechanism, and pattern of injury with each type of nerve injury is important for the prevention of NIPP. Intraoperative neurosurgery is used to detect peripheral nerve conduction abnormalities indicating peripheral nerve stress under general anesthesia and to guide correction of upper extremity position to prevent NIPP. POVL often leads to permanent vision loss. Most cases are associated with spinal stretching procedures in the prone position under general anesthesia. The most common causes of POVL after spine surgery are ischemic optic neuropathy, and neuropathy is the most common cause of POVL after spinal surgery. It is important for spine surgeons to be ware of POVL and to participate in safe and collaborative perioperative care for spine patients. Proper training of perioperative staff, combined with clear communication and cooperation when positioning the patient in the operating room, is the best and safest approach. Prevention of rare complications of spine surgery depends primarily on identification of high-risk patients, correct placement of the, and optimal management of intraoperative physiological parameters. Modification of risk factors external to the patient may help reduce the incidence of PPNI and POVL.