A quick look at some studies related to helicopter medevac are probably in order to discuss how the industry is progressing. We all know that safety and helicopter accidents claiming lives are of paramount importance. In light of the high number of accidents, I think it is a fair question to ask is helicopter medevac as profitable as one might think? There are indications that only a small number of patients actually benefit from helicopter transfer because EMS providers may summon a helicopter even though the patient’s condition may not warrant their use. A helicopter may not always be the fastest way to the hospital, because of problems of being able to land nearby. A study found that 22.8% of patients possibly benefited from helicopter transport. 33.5% of those transported by helicopter were discharged from the emergency department. 85% of patients were considered to have minor injuries. Of the patients transported by helicopter 33% were discharged from the ER and not admitted to the hospital. Given the increasing cost of medical care, it is timely to question whether or not medical helicopters are really in the best service of those in need who more than likely are located in rural areas. Years ago, E.V Kuhlman said, “For the ill-informed, helicopter medevac is not a money maker.” Given the high cost of launching and operating a service, insurance and possible lawsuits that may come as a result of accidents, is it really profitable? Eckstein M, Jantos T, Kelly N, et al. Helicopter transport of pediatric trauma patients in an urban emergency medical services system: A critical analysis. J Trauma 5:340–344, 2002.