A surgical head holder for skull stabilization during neurosurgical and orthopedic procedures, the surgical head holder comprising: a table attachment adapted to be selectively and rigidly coupled to an operating table, the table attachment including an adjustable vertical body, a horizontal generally u-shaped bar adjustably intersecting with said body, and an attachment member extending therefrom for coupling to the operating table; the horizontal generally u-shaped bar defining a horizontal plane having two first axes and a second axis of surgical accessory attachment; an unobstructed operating window providing access from an operating position to a surgical incision; the two first axes of surgical accessory attachment run parallel to the attachment member and operating table to laterally offset a first surgical accessory from the unobstructed operating window and remove unnecessary portions of the first surgical accessory from the unobstructed operating window; the second axis of surgical accessory attachment provides coupling for the second surgical accessory which is required to be within the surgeon's general line-of-sight, and outside and below the unobstructed operating window; a head support adapted to be positioned subjacent to and to provide support to a weight of a skull, the head support configured to accept the skull in a position selected from the group consisting of prone, supine, lateral and combinations thereof; a base member coupled to the head support and at least partially circumscribing a perimeter thereof, the base member having respective channels, the base member being adjustably coupled to the table attachment; a plurality of placement subassemblies circumferentially adjustably positioned and secured to the respective channels (46, 48) of the base member, each placement subassembly configured to receive a skull pin and provide adjustable horizontal, vertical, and angular positioning of the skull pin with respect to the arcuate base; each of the skull pins adapted to provide lateral discrete pressure to the skull in order to stabilize the skull, each of the skull pins being non-weight supporting; the head support configured to support the weight of the skull and the skull pins configured to provide lateral discrete pressure, thereby stabilizing the skull and separating the dual functions of support and fixation; and the first and second surgical accessories coupled to the horizontal, generally u-shaped bar, the first surgical accessory coupled to one of the first axes and the second surgical accessory coupled to the second axis. a table attachment adapted to be selectively and rigidly coupled to an operating table, the table attachment including an adjustable vertical body, a horizontal generally u-shaped bar adjustably intersecting with said body, and an attachment member extending therefrom for coupling to the operating table; the horizontal generally u-shaped bar defining a horizontal plane having two first axes and a second axis of surgical accessory attachment; an unobstructed operating window providing access from an operating position to a surgical incision; the two first axes of surgical accessory attachment run parallel to the attachment member and operating table to laterally offset a first surgical accessory from the unobstructed operating window and remove unnecessary portions of the first surgical accessory from the unobstructed operating window; the second axis of surgical accessory attachment provides coupling for the second surgical accessory which is required to be within the surgeon's general line-of-sight, and outside and below the unobstructed operating window; a head support adapted to be positioned subjacent to and to provide support to a weight of a skull, the head support configured to accept the skull in a position selected from the group consisting of prone, supine, lateral and combinations thereof; a base member coupled to the head support and at least partially circumscribing a perimeter thereof, the base member having respective channels, the base member being adjustably coupled to the table attachment; a plurality of placement subassemblies circumferentially adjustably positioned and secured to the respective channels (46, 48) of the base member, each placement subassembly configured to receive a skull pin and provide adjustable horizontal, vertical, and angular positioning of the skull pin with respect to the arcuate base; each of the skull pins adapted to provide lateral discrete pressure to the skull in order to stabilize the skull, each of the skull pins being non-weight supporting; the head support configured to support the weight of the skull and the skull pins configured to provide lateral discrete pressure, thereby stabilizing the skull and separating the dual functions of support and fixation; and the first and second surgical accessories coupled to the horizontal, generally u-shaped bar, the first surgical accessory coupled to one of the first axes and the second surgical accessory coupled to the second axis.