A retrospective review of all casualties received related to Operations Desert Shield and Desert Storm was conducted at Madigan Army Medical Center. Of the 180 patients determined to have returned from the Persian Gulf theater of operations, 93 (52%) had at least one orthopedic diagnosis and 84 (45%) were transported with a primary orthopedic diagnosis. The evacuation diagnosis was not substantiated by medical center evaluation in 37 (40%), and 42 (45%) were returned to duty without further treatment. Thirty-five patients (38%) were evacuated for a condition for which they had previously been profiled at least once. Peacetime duty limitations must be accurate and appropriate with respect to potential wartime demands.