The COVID-19 pandemic has presented a unique and challenging environment for aeromedical organisations. We present lessons learnt during the development and implementation of our operational processes and procedures at The Royal Flying Doctor Service (RFDS) Western Operations for the transfer of suspected COVID-19 patients. To date, we have conducted 105 such fixed-wing transfers. The unique geography and health care system of Western Australia mandates that long-range, fixed-wing transfers are often required to centralised tertiary care. These lessons learnt provide a framework for the essential logistical, equipment and human factor considerations for developing an effective system. The translation of predominantly hospital-centric protocols into the aviation environment requires careful forethought, effective leadership and teamwork. Conducting COVID-19 suspected aeromedical retrievals significantly impacts all aeromedical retrieval operations and aeromedical personnel that should be realised by an aeromedical organisation.