Safety in the operating room environment should be a priority for every surgeon. Two areas where safety can often be overlooked and taken for granted are patient positioning and electrosurgical use. Understanding neuroanatomical relationships can help the surgeon optimally position patients and minimize the incidence of postoperative neuropathy while maintaining functional and unobstructed access to the patient and surgical field. Given the widespread use of radiofrequency devices in daily surgical practice, a working knowledge of the principles of electrosurgery is vital to the gynecologic surgeon. Although electrothermal injuries are rare, they can be devastating when unrecognized and poorly understood. Advances in the safety and efficacy of these instruments will continue to aid in decreasing the risks associated with electrosurgery.