The NATO litter serves as a transport device and hospital bed during all types of operations. Little is known about the skin interface pressure on this litter. The purpose of this study was to determine whether various types of padding on the litter and body position affect the peak skin interface pressure and the total body area exposed to interface pressures above 30 mm Hg at different body areas. Thirty-two subjects participated. A repeated measures design was used. The surface effect was statistically significant for all peak pressure and surface area analyses (repeated-measures analysis of variance, p < 0.01). There was a significant decrease in peak pressure and surface area between the litter and litter plus aeromedical evacuation mattress. The addition of the blanket did not significantly reduce pressures and should not be considered a pressure-reducing measure. Conversely, an aeromedical evacuation mattress should be used for all high-risk patients if feasible. Preventive measures (turning, elevating the heels) are still required.