ABSTRACT Objectives Aerial transport of injured patients in rural Southeastern Ecuador is provided by humanitarian organizations with no medical personnel or assistance. We sought to evaluate the feasibility and usefulness of a tailored aeromedical transport (AMT) course for nonmedical personnel (pilot and technicians) in the jungles of Ecuador, where there are no formal medical crew members. Methods Fixed-wing aeromedical flights in the Amazon province of Morona Santiago were analyzed to delineate the injury patterns (IP) and reason for transport (RFT). An 8-hour didactic and hands-on AMTC course based on IP and RFT was developed and administered by the Virginia Commonwealth University (VCU) International trauma system development program (ITSDP) and VCU Life Evac with extensive experience in aeromedical education and training. Pre- and post-test course evaluation was used to assess the medical background and knowledge retention of the participants. Results A total of 5,716 fixed-wing aeromedical transports between Jan 2003 and Dec 2005 were analyzed. The course was developed based on 1176 (20%) RFT resulting from traumatic injuries. Course structure based on identified IP included 4 didactic lectures and hands-on skill training in aerial physiology, airway management, bleeding control, shock, musculoskeletal injuries, immobilization and patient transport. Fifteen students (4 pilots, 4 engineers, 2 physicians, 4 aerial staff and 1 flight operator) participated in the course. Pre- and post-test evaluations demonstrated significant improvement in knowledge from 53% (average 10.53, STD 1.6) to 73% (average 14.53, STD 2.13) p-value < 0.0001). Critical deficiencies in information uptake were identified in airway management and flight physiology Conclusion A tailored AMTC may serve as the first step toward the development of a regionally specific aeromedical transport service. Long-term follow-up is needed to evaluate the real impact of this intervention in terms of morbidity and mortality. How to cite this article Aboutanos MB, Mora FE, Nicholson B, Lovelady J, Dhindsa H, Mata LV, Kleiman D, Chin T, King A, Ivatury RR. Trauma Course for an Aerial Medical Transport System in the Amazon Rainforest of Ecuador. Panam J Trauma Critical Care Emerg Surg 2012;1(1):1-5.