Respiratory considerations in aeromedically evacuated patients are the cornerstone of safe, successful transport. Maintenance of the ABCs and ongoing resuscitation including pulmonary/ventilator stabilization and management en route are paramount. All of these goals are predicated on a well-developed understanding of hypobaric pulmonary physiology and hypobaric effects on medical devices, a solid grasp of the inherent limits of an aeromedical environment, and the resolute accomplishment of both initial and follow-up team member training.