The development of manned sub-orbital commercial space vehicles is rapidly occurring and flight testing followed by operational flights will soon begin. The experience of manned suborbital spaceflight at the designated altitude (100 km/62.14 mi) is very limited--two Mercury-Redstone flights, two X-15 flights, one inadvertent Soyuz launch abort, and three recent SpaceShipOne flights, with only 15 min of critical flight time each. All indications were that the sequence of acceleration-weightlessness-deceleration was well tolerated with minimal neurovestibular dysfunction. However, there are some indications that distraction and spatial disorientation did occur. Vertigo on transition from the boost phase to weightlessness was reported on most high-altitude X-15 flights. +Gz tolerance to re-entry deceleration forces (as high as 6 + Gz) after 4 min of weightlessness is still unknown. Only further suborbital spaceflight experience will clarify if pilot performance will be affected.