Early references to aeromedical transportation do not address the movement of psychiatric patients. They were specifically excluded from routine movement by air early in World War II, but their movement by returning troop ship had an unacceptable rate of mortality and morbidity. The tactical experience in this matter acquired by battlefield necessity led to the use of an aeromedical classification system indicating the need for restrains, sedation, and properly trained attendants. This time-tested system is used today in almost identical form. Most of these patients require only the good medical care and common courtesy that other patients require. A few may cause anxiety because of their attitudes or actions. Proper preflight planning includes giving patients accurate information, dealing with their situational anxieties, considering the aeromedical implications of psychotropic medications, anticipating disruptive behavior, and using interpersonal skills to lessen anxiety in flight.