Successful disaster aeromedical evacuation depends on applying the principles learned by moving patients since World War II, culminating in today's global patient movement system. This article describes the role of the Department of Defense patient movement system in providing defense support to civil authorities during the 2008 hurricane season and the international disaster response to the 2010 Haiti earthquake. Adapting and applying the principles of active partnerships, establishing patient movement requirements, patient preparation, and in-transit visibility have resulted in the successful aeromedical evacuation of over 1,600 patients since the federal response to Hurricane Katrina.