Air ambulances: ‘The (flying) doctor will see you now’

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by Mike Stones

April 15, 2026

The air ambulance sector is blossoming nearly 100 years after the founding of the Royal Flying Doctor Service, in Queensland Australia.

Not many remember the Reverend John Flynn today. But 98 years ago, he founded the Royal Flying Doctor Service, in Queensland Australia. Nearly a century later, the civilian air ambulance industry has blossomed worldwide. Further growth is predicted in the years to 2030, according to flight data consultancy WINGX Advance.

“A key tailwind supporting continued growth is the aging demographic in developed markets, particularly in North America, Europe and Australia,” says Richard Koe, MD of WINGX. “This will drive increased demand for rapid medical transport services as elderly populations require more emergency and specialised care.”

The result is likely to be modest growth in the years to 2030, with low single-digit annual growth rates as the sector matures beyond its post-pandemic expansion phase, he says. Covid kickstarted the industry. Since 2019, it has seen 55% increase representing a 7.6% compound annual growth rate, says the consultancy. Koe puts it like this: “The sector saw a step-change following the pandemic, with steady expansion from the 2020 lows through 2025. This represents one of the strongest growth trajectories in business aviation operations during this period. Obviously – fingers crossed – that’s a one-off spike.”

But growth has moderated from pandemic-era peaks. “Last year showed the slowest year-over-year expansion of air ambulance services in the recent period,” Koe tells us. “The sector appears to be transitioning from rapid expansion to steady, sustainable growth.”

Ageing populations

Continued growth is not simply due to aging populations in developed markets requiring more medical transport. Other factors include rising geographic coverage of air ambulance services and greater acceptance of air medical transport as standard care.

Global air ambulance activity reached more than 220,000 departures across business jets and turboprops in the first 11 months of last year. This is 3% up on the same period in 2024. Turboprop operations climbed 5% year-over-year, accounting for 76% of all flights. Jets represented 24% of activity and dipped by 1%. “The split reflects the operational realities of air ambulance missions, where turboprops offer cost-effectiveness and capability for shorter range medical transports,” explains Koe.

He also points out the data excludes piston aircraft and is based on global ATC [air traffic control) and ADSB (Automatic Dependent Surveillance Broadcast) records. Plus, WINGX tracks known medical/ambulance operators. Additional flights are flown ad hoc by aircraft normally flying passenger or cargo charter.

Reflecting the air ambulance industry’s origins, the Royal Flying Doctor Service leads the sector with more than 60,500 departures last year. This represents more than one-quarter of all global air ambulance flights, according to WINGX data.

Air Methods

Guardian Flight ranks second with about 25,000 flights, followed by Babcock Scandinavian Air Ambulance with nearly 13,000 operations. Air Methods operates more than 9,200 flights (ranking fourth), while CSI Aviation Services completes the top five with about 8,600 departures. Together, the five operators account for about 53% of all air ambulance activity tracked through the first 11 months of 2025.

Turning to aircraft types, the Pilatus PC-12 leads all air ambulance aircraft with nearly 70,000 departures, representing 32% of flights, in the first 11 months of last year. The Beechcraft King Air 200 ranks second with about 60,000 flights claiming a 27% share of the market. Together, the two types account for nearly 60% of all air ambulance missions.

Other significant aircraft flying air ambulance missions include the King Air 90, accounting for 10% of missions, and the King Air 350 and Learjet 45. Each make up 5% of flights, together accounting for 10% of total flights. “The top 20 aircraft types show strong representation from both turboprops and light to midsize jets, with turboprops dominating due to their operational flexibility and economics,” says Koe.

Not surprisingly, the US dominates air ambulance operations with more than 95,000 departures, accounting for 43% of global missions, in the first 11 months of last year. Turboprop flights represented 83% of US flights.

Top five countries

Australia ranks second with nearly 71,000 flights and shows even stronger preference for turboprops, which make up 91% of operations. Completing the top five countries, Norway had 13,000 flights, Canada 9,300 flights with Sweden accounting for 5,500 air ambulance missions. “These five nations account for about 88% of global air ambulance activity, highlighting the concentration in developed markets with large geographic areas and dispersed populations,” says Koe.

Diving deeper into the statistics reveals significant regional variations. Compared with the global average of 24% of all missions, jet deployments in Sweden account for 99% of flights and in Germany 74% of missions. Newer types, such as the Pilatus PC-24 and Citation Latitude, are proving more popular as fleets are modernised.
Fleet strategies also vary with Australia’s Royal Flying Doctor Service operating nearly 80 aircraft while Swiss Air Ambulance achieves significant activity with just three aircraft.

“The sector demonstrates resilience and adaptability, with different regional models succeeding based on local geography, regulations, and healthcare systems,” says Koe. The sector will need all that flexibility as it grapples with rising operational costs, including fuel prices and aircraft maintenance expenses, and pilot shortages, he adds. It could prove a toxic cocktail that pressures profit margins and limit fleet expansion for operators.

Nevertheless, WINGX believes the sector’s growth (albeit modest) is assured. “Despite the challenges, the fundamental need for air ambulance services in geographically dispersed regions ensures the sector will remain an essential component of healthcare infrastructure,” says Koe.

Meanwhile, tracing nearly a century of progress in aero engineering, PC-24 jets are now carrying on the work of the Royal Flying Doctor Service. A service that began with the Reverend John Flynn’s lumbering, single-engine de-Havilland DH.50 biplane in Cloncurry, Queensland.

Corporate Jet Investor H1 2026 magazine

This article was first published in Corporate Jet Investor H1 2026 magazine. Click this link to read the full digital version of this article or sign up for your free hard copy of the magazine here. The current edition also profiles the views of leading air ambulance operators including: European Air Ambulance, Aero-Dienst, FAI Medical Services plus others.