Patients experiencing cardiac arrest secondary to trauma make up 8% to 15% of air ambulance scene flights in reported series. Our study examined the role of aggressive physician intervention at the accident scene in conjunction with rapid air transport to a trauma center in reducing the mortality after post-traumatic cardiac arrest. We retrospectively studied 67 patients who experienced cardiac arrest before the arrival of the flight team. Fifty-eight patients were victims of blunt trauma, and nine sustained penetrating trauma. Forty-seven patients were transported to the base hospital; 20 were pronounced dead at the scene after resuscitation attempts were made. Six patients developed a pulse and blood pressure and were hospitalized; none survived to hospital discharge. Review of autopsy data revealed that the majority of patients had head or thoracoabdominal injuries or both that were incompatible with life. We conclude that physician intervention at the scene and rapid aeromedical transport are not likely to improve mortality after traumatic cardiac arrest.