This article explores the use of side rails within the context of physical restraint in gerontological practice. It is debated that side rails can be considered as a form of physical restraint if the individual cannot voluntarily remove/lower the device if he/she wishes to do so. The value of side rails as a protective medium is debated with regard to their association with injuries sustained as a result. Side rails should be used with caution and within a risk management context. Frailty should not be an indicator for the use of side rails, an individualized approach to determine patient's suitability to side rails is advocated.