Methods and devices are provided for providing surgical access into a body cavity. In one embodiment, a surgical access device is provided that includes an elongate hollow tube having a proximal end that is configured to be positioned adjacent to a tissue surface and a distal end configured to extend through a body wall into a body cavity. The proximal end of the device can be can be configured to allow the proximal-most portion of the surgical access device to rest flush or substantially flush against a tissue surface of a patient when the device is inserted into the patient. In some embodiments, the elongate hollow tube can have a non-circular cross-section.