A surgical head holder and accessories for use with the same are disclosed. In one embodiment, a horseshoe shaped head support includes two wings pivotally coupled that adjust the angle therebetween. Arcuate base members are coupled to the wings to accept a plurality of placement subassemblies, which are circumferentially adjustably positioned and secured within the channels. Each placement subassembly is configured to receive a skull pin and provide adjustable horizontal, vertical, and angular positioning of the skull pin with respect to the arcuate base. A table attachment supports the horseshoe shaped head support and is adapted to be selectively and rigidly coupled to an operating table. The table attachment includes a vertical body, a horizontal generally u-shaped bar adjustably intersecting therewith, and an attachment member extending therefrom for coupling to the operating table. Various neurosurgical accessories may be rigidly coupled to the table attachment.
