Throughout the 20th century, military and civilian medicine has been inextricably linked, resulting in changes in practice for both systems. Each successive military encounter contributes new knowledge to the growing pool of improvements in trauma care. Recent military engagements have demonstrated a change in modern warfare that calls for flexibility and creativity in adapting to those changes, especially in the medical management of combat casualties. With the decreasing size of battlefields and routine use of air evacuation comes the decrease in time from point of injury to definitive care; a goal shared by civilian and military trauma doctrine. The location and mission of combat support hospitals in Iraq afford a unique opportunity to combine the concepts of civilian trauma care with existing military concepts with the goal of improving the outcomes of combat casualties.