In remote areas and in developing countries, where adequate health-care structures are few and sparse, Occupational Medicine contributes to guaranteeing workers' health. Companies like Saipem, involved in activities that are carried out in remote, inhospitable areas must ensure the safety and guarantee the health conditions of workers in relation to the risk factors connected with the job as well as with the environment in which it is performed. In such situations, Occupational Medicine addresses both the health aspects of the workplace and of the community, and is the pivot around which revolves the health-care support of workers employed abroad in the sense of protection and enhancement of health. The risks connected with work abroad are of three main types: 1) job-related risks; 2) risks connected with the environment; 3) risks related to the organization of work and the changes in the worker's daily life. The job-related risks are similar to those connected with analogous jobs performed elsewhere. The risks connected with the environment are related to adverse climatic conditions, extreme temperatures and unknown and often dangerous flora and fauna. The occupational physician is called upon to assess the suitability of workers for jobs that are based in remote areas. The main clinical conditions that can prevent issue of the Medical Fitness Certificate to workers for long-stay jobs abroad are discussed.