A hybrid operating room with support structure. The hybrid operating room includes an interior for use in the imaging of and performance of surgery on a patient, the interior including a ceiling. The hybrid operating room also includes a support assembly positioned above the unit for supporting equipment used in conjunction with such imaging and surgery so that the equipment extends downwardly from the ceiling into the interior. The support assembly is designed to support a load of at least 3,500 pounds, and more in certain implementations.