This video provides a step-by-step demonstration of preprocedural neuraxial ultrasound for lumbar neuraxial procedures. The film shows probe selection and orientation, sonoanatomy landmarks (sagittal and transverse views), measurement of skin-to-posterior complex depth, and skin marking. Indications and evidence for improved procedural accuracy and reduced needle passes are discussed. The technique is applicable to routine obstetric neuraxial procedures and is especially useful in patients with challenging surface landmarks or a history of difficult neuraxial placement.