This epidemiologic study was aimed at detecting determinants of acute inflight neck pain. It followed a cohort of 66 student fighter pilots from 1 to 3 years. These pilots were frequently exposed to high +Gz forces. The number of flight hours, strenuousness of work, job satisfaction, symptoms suggesting psychologic distress, smoking habits, and the frequency of muscle strength, muscle endurance, and aerobic training were investigated by questionnaires at the beginning and end of the follow-up period. Physical examination, consisting of measurement of height, body weight, body mass index, head and neck circumference, passive cervical range of motion, grip strength, and isometric strength of neck muscles was done only at the beginning of the study. The cumulative incidence of acute inflight neck pain was 37.9%. The number of flight hours was found to be the only significant determinant of acute inflight neck pain.