BACKGROUND: Hiking is a very popular sport in Hong Kong. Serious injuries can sometimes occur in the remote areas not accessible to roads. Aeromedical evacuation service is run by the Government Flying Service (GFS) with emergency physicians and nurses as volunteers in Hong Kong. In this paper we describe the profile and outcome of injured hikers rescued by the GFS. METHODS: In this retrospective review, nature of the complaints, medical team composition, vital signs, clinical assessment and diagnosis on site were collected from the GFS medical record. Demographic data, final diagnoses and outcomes of the patients were retrieved from emergency department (ED) and hospital discharge records. RESULTS: A total of 275 cases were recruited for the 3-year period from January 2003 to December 2005. The mean age of the group was 39 years (range 1-83) with more males (159, 58％) than females. Heat illnesses, injuries and medical problems each constituted about one third of the cases. Lower limb injuries accounted for nearly half of the injuries. About 30％ of the rescued hikers did not register to be seen at the ED. Only 48 hikers (17.5％) required admission and four were admitted to intensive/coronary care units for heat stroke and acute coronary syndrome. Five cases of pre-hospital cardiac arrest were recorded. CONCLUSION: Most hikers evacuated by the GFS did not suffer from serious conditions. GFS should still be prepared for the occasional cases that require advanced life support.