ObjectiveOverseas Koreans face challenges in accessing adequate medical care abroad. Understanding the epidemiology and costs of international medical repatriation is important. MethodsA retrospective analysis of overseas Korean patients who were repatriated to South Korea between 2019 and 2021 was conducted. The data collected from 121 countries included demographics, medical conditions, and costs. Variables from 9 continents (Southeast Asia, Northeast Asia, Southwest Asia–Pacific, Russia–Central Asia, North America, Central and South America, Europe, Middle East‒North Africa, and Sub-Saharan Africa) and the era of coronavirus disease 2019 (February 2020 and after) were analyzed and compared. Based on the available total cost data, stepwise extrapolation was conducted for the total cohort. ResultsA total of 428 overseas Korean patients who had undergone international medical repatriation via air transport were included in this study. The greatest number of repatriated patients were from Southeast Asia (108 patients), and 279 patients were transported within the coronavirus disease 2019 era. The average cost per patient exceeded $7,000, and the total cost estimated by extrapolation was over $8 million. ConclusionInternational medical repatriation is significant for overseas Koreans. Standardized guidelines and system development are essential for effective air medical services.