PURPOSE: Exposure to hostile environment as experienced in flying high performance aircraft, such as changes in acceleration, atmospheric pressure, hypoxia, vibration, and temperature, has been attributed to cardiac function of pilot. The inflight aerial combat environment is one where multistressors with various factors occurs simul-taneously. Accordingly, to evaluate the effects of actual flight with aerial combat mission on cardiac function, we analyzed echocardiograms of 22 pilots before and immediate after actual flight. METHODS: 22 healthy male pilots (mean age 31.00 years) who fly high performance aircraft in F-4D fighter squadrons were included in this study. Baseline echocardiograms with questionnaire were performed before flight. Echocardiograms including individual questionnaire were repeated within 30 min. after flight. Each subject served his own control. We analyzed the different echocardiographic parameters (LVEDD, LVESD, Ao. Root Diam., LA Diam., IVST, LVPWT, EPSS, EF slope, LVEDV, LVESV, E/A Ratio, EF, FS, LV Mass, D-Ao. Flow, D-Pulm. Flow). RESULTS: Mean F-4 flying time of 22 pilots was 663.59 h. By paired-t test, no significant differences were founded between pre-baseline and repeated echocardiographic parameters. One pilot was found to have minimal mitral regurgitation without mitral leaflet thickening or redundancy on color doppler echocardiography. CONCLUSION: We found no significant dif-ferences in cardiac functions after actual flight when compared to pre-baseline cardiac functions.