This was an observational study that continuously monitored intracranial pressure (ICP) of traumatic brain injury (TBI) patients during in-theater aeromedical transport of Air Force Critical Care Air Transport Team casualties during flights from Bagram to Landstuhl Regional Medical Center and from Landstuhl to the U.S., as well as in-hospital transport from the intensive care unit to computed tomography scan. There were complete data on 11 patients in the aeromedical portion of the study and 7 patients in the in-hospital portion. Data analysis showed that in both the in-theater and in-hospital portions of the study, some patients experienced many instances of ICP 20 mmHg while others experienced none. All but one patient in each group experienced an ICP fluctuation of ? 50% of baseline ICP. Overall, in-hospital transport and movement to and from the computed tomography table produced larger ICP increases than during aeromedical transport. It is unclear if there was a mortality effect of the ICP variations due to the observational nature of the study. A larger study including the in-flight and post-flight medical records would be needed to determine the overall effect of transport.