BACKGROUND: The selection of a neurosurgical sitting position (SP) regarding complication avoidance is a much-debated topic in neurosurgery and anesthesiology. In this bibliometric analysis, we examined the 100 most cited neurosurgical and anesthesiology SP articles focused on posterior fossa surgery. METHODS: The Scopus database was searched on January 25, 2025, for keywords: "neurosurgery" OR "neurological surgery" OR "anesthesiology" AND variations of "sitting" including "semisitting," "seated," "half sitting," "halfseated," "upright," and "lounging," and for "air embolism." The 100 most cited of the 2835 articles found were then reviewed in detail. RESULTS: The 100 most cited papers were published between 1964 and 2019. Venous air embolism (VAE) was the most common complication, discussed in 52 articles, with reported VAE incidences varying from 0% to 100% (median, 20%). Incidences of paradoxic air embolism ranged from 0% to 14% (median, 0%) of cases, with mortality related to VAE ranging from 0% to 0.5% (median, 0%). VAE detection methods differed throughout the years and among institutions, but how VAE was managed was similar in most reports from all institutions. Of SP reports, 61% originated from anesthesiology departments and 36% from neurosurgery departments. Nearly all reports were published in anesthesiology (51%) or neurosurgical journals (45%), with only 4% in other journal disciplines. CONCLUSIONS: The use of an SP is often debated in neurosurgery and anesthesiology. This bibliometric analysis summarizes the most cited reports to provide a guide for neurosurgeons and anesthesiologists for diagnostic evaluation, complication avoidance, and surgical management.