Air travel of persons with coronary heart disease, heart failure and cyanotic congenital heart disease will be without complications and problems in the most cases. Prerequisite for an uneventful flight are stable cardiac conditions and an extensive cardiac examination including echocardiography and exercise testing before starting the journey. Careful travel planning and timing to reduce travel stress is mandatory. To determine fitness for air travel left heart catheterization is required in most patients with acute coronary syndrome. Patients with an acute coronary syndrome may repatriated with medical escort within the first 2 weeks after the acute event. Patients with a low risk profile can fly with reasonable safety 14 to 21 days after the acute event without medical escort. Fitness to travel may be given within a few days after successful percutaneous coronary intervention in individual cases. Patients with severe acute cardiovascular diseases and an appropriate medical indication may be transferred by air ambulance after acute local medical care and pretransfer stabilisation with ambulance jet under intensive care conditions. In these cases close cooperation between the doctor in charge, cardiologist and cardiologic department respectively and air ambulance is mandatory.