Background: Axillary brachial plexus (ABP) block is commonly performed as the primary anesthetic technique to provide surgical anesthesia and postoperative analgesia for elbow, forearm and hand surgery. Compared to general anesthesia, ABP blocks have been shown to result in better pain relief, less nausea and vomiting, shortened length of hospital stay, decreased side effects of opioids painkillers and better patient satisfaction. These beneficial effects of ABP blocks are particularly useful for patients who are overweight or obese as this cohort is at a higher risk of experiencing complications from general anesthesia. Traditionally, nerve blocks have been described technically challenging in obese patients. This may not be true now with availability of high-resolution ultrasonography (US). US imaging also allows doctors the ability to visualize the needle "live" to allow for more accurate needle placement. This allows local anesthetic to be placed more precisely resulting in faster onset anesthesia, decreased local anesthetic drug dosages, reduced complications and higher success rate. Ultrasound guidance has not been used for performing ABP block in previous studies in obese patients.