During a 3-month deployment to Silopi, Turkey, for Operation Provide Comfort, the 39 TACG Air Transportable Hospital (ATH) managed 32 cases of severe military trauma. Fifty-two operations were necessary, 78% of which were performed at the ATH. Advanced Trauma Life Support (ATLS) protocols were applied to all of the patients. Only 14% of the 52 procedures were ATLS-learned skills. Also, only 30% of the patients could be managed solely by ATLS in the first 6 hours, the average time of ATH responsibility. ATLS alone is insufficient wartime readiness preparation for the military physician.