We compared the effect of the lithotomy position on the systolic blood pressure (SBP) with the horizontal position after spinal block. The lithotomy position was performed 5 min after spinal block. The change in SBP was expressed as percent of depression from the baseline value. The SBP increased by the lithotomy position (n = 14) from a 16% decrease to an 8% decrease. On the contrary, in the horizontal group (n = 14), SBP decreased 16% at 5 min and continued to decrease to 21%. The extent of the cephalad spread of analgesia 20 min after spinal block was same between the two groups (T-5 +/- 2 vs T-5 +/- 2, respectively). From these results we conclude that the lithotomy position after spinal anesthesia attenuates the decrease in arterial blood pressure and does not affect the cephalad spread of analgesia.