(Anesth Analg. 2021;133:1235–1243) A lateral tilt of the uterus is used to reduce pressure on the inferior vena cava in pregnant patients undergoing cesarean delivery. This may improve the fetal blood and oxygen supply. This position has been thought to improve the fetal acid-base status, though this has been recently called into question. This study aimed to evaluate whether moving the patient into a 30 degrees left lateral tilt position before elective cesarean delivery with combined spinal-epidural anesthesia could better improve the fetal acid-base status compared with a 15 degrees left lateral tilt or supine position.