PURPOSE: To report a positioning method for macular laser photocoagulation in obese or large-breasted patients. DESIGN: Report of a laser technique. METHODS: Review of clinical experience. SETTING: Private retina practice. RESULTS: Standing the patient up, leaning forward, and using the examination chair as buttocks support allows easier positioning of the obese or large-breasted patient in the slit lamp. The laser surgeon's hand manipulating the slit-lamp joystick does not fatigue, which allows more careful examination and treatment in these delicate cases. CONCLUSIONS: The technique described may allow more thorough diagnostic evaluation and focal laser treatment of obese and large-breasted patients with macular diseases.