The prevention and treatment of pressure ulcers are major concerns for health care providers across the care continuum. The selection of a support surface is an important component of a comprehensive pressure ulcer prevention program. The accepted standard in clinical practice for pre-venting pressure ulcers and other complications of immobility is to either turn patients manually at frequent intervals or to use a pressure-reducing device. The longer a patient is immobilized, the more profound will be the systemic complications. The costs associated with the complications of immobility are staggering in terms of human suffering, physiologic damage,and real dollars. A variety of specialty beds, mattresses, and overlays have been designed to address pressure, shear, friction, and moisture. Limited data exist regarding the efficacy of these products. Clinicians want to choose a support surface for their patients on the basis of product performance. With the push toward establishing standards for testing methods and reporting information, clinicians can look forward to making support surface decisions based on the evidence and outcome data resulting from controlled clinical studies and expert opinion and consensus.