Many surgeries have to be performed in the prone position. Access to central vessels is very limited in this position. This requires forward planning with regard to the placement of a central venous catheter. Emergency situations or unexpected intraoperative events in prone position are challenging, as a conventional central venous access is not possible. We describe the cannulation of the popliteal vein in such a case. We report the case of a patient with severe intracerebral hemorrhage who was transferred to our emergency department where his clinical condition rapidly deteriorated. Due to the surgical approach, a prone position was necessary and preoperative central venous cannulation was not possible. We therefore performed an alternative vascular access in prone position using a ultrasound-guided cannulation of the popliteal vein. The cannulation of the popliteal vein described here can be carried out as a quick and easy feasible alternative in emergency situations in prone position. The ultrasound-guided catheter insertion succeeded without any problems and there was no evidence of a deep vein thrombosis after the intervention.