A patient positioning device includes a planar sheet having removably connected padded substrates attached proximal to the patient's arms. The padded substrates are wrapped around the patient's respective arms to protect and elevate the arms from the underlying table or gurney. Leggings are also provided to protect the patient's legs. The padded substrates include splits to allow wires and cables to pass through without getting tangled. A secondary sheet is attachable to the device to cocoon the patient when the patient is rolled over. A shoulder strap is provided under the patients shoulders, wrapping around and over the shoulders at the trapezius and at the shoulder cuff and is secured to the padded substrates for additional protection and security. The device has a low friction bottom surface to ease transfer and positioning.