This paper explorers the early days of patient evacuation and the beginning of formalized military training for nurses in aeromedical evacuation during World War II. It then outlines the primary aircraft used for aeromedical evacuation and the structure of these units before and after the Air Force Reserve reorganization, June 1992. The paper examines the critical issues of recruiting and retention. It also looks at Reserve requirements, the impact of personnel time constraints, and the training time involved in accomplishing initial aeromedical evacuation qualification. The final section concludes with six recommendations for the emerging aeromedical evacuation system of tomorrow.