Patient falls in the operating room environment pose a significant safety issue due to anesthesia, limited mobility, and the nature of the surgical procedure. This risk arises from a combination of patient-related characteristics, environmental conditions, individual errors by team members, and organizational deficiencies. Systematic risk assessment in the preoperative period, safe transfer during the intraoperative process, proper positioning, periodic equipment checks, and close observation in the postoperative period are fundamental protective measures. Strengthening the safety culture, supporting intra-team communication with standard tools, and sharing reports and root cause analyses contribute to the prevention of falls and near misses. In addition, current guidelines and institutional policies guide practices, while innovative solutions such as sensor-equipped surgical tables, electronic warning systems, and multidisciplinary prevention packages support the process. In conclusion, preventing patient falls in the operating room requires a comprehensive, safety culture-based, and technology-supported multidisciplinary approach.