Patients suffering from toxicological emergencies (TE) represent a small and previously unreported subset of aeromedical transport patients. We analyzed data from a large multicenter study of aeromedical transport patients to identify the percentage of patients transported for TE; we also assessed both severity of illness and requirements for care. Of 1,927 patient flights 32 (1.7%) were for TE. The TE patients had similar APACHE II scores compared to the remainder of the group (12 + 2 vs. 11 ± 0.2) and significantly lower TISS scores (20 ± 2.3 vs. 27 ± 0.4). An in-depth case review of 35 TE patients transported by our two flight programs was also undertaken. In 16 of 35 patients the flight team was judged to have added a significant therapeutic intervention. Three of 35 patients ultimately expired. Two of the three patients died of problems from instability during flight. The review revealed some important considerations for programs undertaking transport of such patients.