BACKGROUND Pilots and crewmembers of flights exceeding 7620 m/mean sea level (msl) are required to complete ground training in high-altitude physiology, including hypoxia training. However, regulations do not require altitude chamber training (ACT). METHODS An anonymous questionnaire concerning their experiences and perceptions of hypoxia training was filled out by 67 pilots attending an aviation safety conference. All pilots had logged professional business flight hours in the previous 6 mo. RESULTS There were 62 pilots who reported receiving hypoxia training, and of these, 71% reported having initial ACT. Most of the pilots surveyed agreed that all pilots should receive introductory hypoxia training (92%), recurrent hypoxia training (86%), initial ACT (85%), and recurrent ACT (70%). Initial ACT received lower endorsements for private (32%) or recreational (10%) pilots than for commercial (74%) and air transport (90%) pilots. When asked if ACT should be based on the altitude capability of an aircraft, 59% responded affirmatively. Apparently, the perceived need for ACT was based on the likelihood of flying at higher altitudes and not simply the level of certification. When asked if the current regulations (i.e., not requiring ACT) addressing high-altitude flying (above 7620 m/msl) are sufficient, 52% of the current sample disagreed or strongly disagreed. CONCLUSIONS Generally, these professional pilots perceived that pilot training should include introductory hypoxia training, recurrent hypoxia training, and ACT. Exceptions were initial ACT for recreational pilots and private pilots. Generalizability of these results may be affected by the specificity and size of the sample. Distributing the survey to a wider audience of pilots would provide additional information regarding perceptions of hypoxia training.