A patient positioning system for positioning a patient in the lateral decubitus position in preparation for a lateral approach spinal procedure. The patient positioning system includes a base section having a head bolster, an axillary bolster, and a hip bolster. The system also includes a lateral arm support configured to support the arms of the patient in a generally parallel position extending in the anterior direction away from the torso of the patient, and a leg bolster positionable between the legs of the patient and configured to support the legs of the patient and space the legs of the patient from one another.