We describe five cases of traumatic asphyxiation injury, each meeting diagnostic criteria for posttraumatic stress disorder (PTSD) and characterized by a range of postinjury cognitive impairment. Four patients exhibited dense retrograde amnesia, including absence of conscious memory for the traumatic event. Appreciation of these asphyxiation cases, which involve temporally extended trauma exposure, may help resolve arguments regarding the possibility of co-occurrence of PTSD and neurological amnesia based exclusively on observations of much briefer duration events (specifically, motor vehicle crashes). These five cases also provide evidence that cognitive symptoms of PTSD can develop in the absence of conscious memory for the event.