Chest pain is a common complaint at medical treatment facilities during combat operations. The initial evaluation focuses on potentially life-threatening conditions (acute coronary syndrome, aortic dissection, pulmonary embolus), in addition to pericarditis and benign musculoskeletal conditions such as costochondritis. Pulmonary arteriovenous malformation is a rare condition, but an important diagnostic consideration in soldiers who present with chest pain and/or hypoxia and in whom other life-threatening conditions, such as cardiovascular disasters and pulmonary embolus, are excluded. We present the case of a male soldier deployed to Operation Iraqi Freedom, who was air-evacuated back to Washington, DC, for definitive care. We present his case and a review of the relevant literatures on the diagnosis and treatment of patients with pulmonary arteriovenous malformations.