Neuromonitoring for patient positioning is incidental to the surgical procedure; however, postoperative deficits caused by limb malposition can profoundly impact a patient’s long-term quality of life. Neurophysiological monitoring serves as an early warning system, detecting potential neurological sequelae arising from limb malposition as it happens in real time. Employing a meticulous approach and adhering to a distal-to-proximal intervention algorithm based on the nerve which is compromised when a neurophysiological modality weakens can effectively reverse potential injuries and mitigate postoperative complications.