A positioning system for securing a patient relative to a surgical table is provided. The system may include a pad body, a plurality of pad straps and a plurality of body straps. The pad body may include an upper body portion, a lower body portion with first and second lower body extensions, and first and second arm extensions corresponding to the respective first and second lower body extensions. The plurality of pad straps may be configured to be positioned through at least one of the upper body and lower body portions. The plurality of body straps and the plurality of pad straps may be configured to engage each other. The system may include a support strip to increase friction and resist movement relative to the surgical table. A method of a positioning system is also provided.