Surgical access stabilization devices, systems, and methods are disclosed herein. For example, the devices, systems, and methods disclosed herein can be used during a surgical procedure to selectively establish, stabilize, and maintain a desired trajectory and/or positioning of a surgical access device. An exemplary surgical access stabilization device can include a pad with an adhesive distal facing surface to adhere to an anchor surface, a surgical access device coupled to the pad, and a locking mechanism to selectively lock a position of the surgical access device relative to the pad. In one embodiment, the anchor surface can be the skin of a patient. An exemplary surgical access device stabilization method can include making an incision in a patient at a surgical site, inserting a surgical access device through the incision, adhering a pad to an anchor surface, e.g., the skin of the patient, coupling the surgical access device to the pad, and selectively locking a position of the surgical access device relative to the pad. Other exemplary devices, systems, and methods are also provided.