Very good with thick foam inside so it doesn't slip on the bed. I take off one star because it only ties at the top of the pillow while it should also tie in the middle because for us the bed railing doesn't reach that high, but even if it did, it would hold it more securely in the middle. I take off another one because the cover doesn't come off if you want to wash it, but (personally) I would put it in the washing machine like that and hope it doesn't get damaged.