Missions conducted by the U.S. Military during combat involve a multitude of operational stressors that can cause deterioration in physical and military performance of soldiers. Physiological consequences of sustained operational stress include decrements in anabolic hormones, skeletal muscle mass, and loss of bone mineral density. The objective of this review is to examine the current literature and provide commanders with information on the physical and physiological decrements in soldiers conducting sustained operations. The intent is that this will provide commanders with insight on how to plan for missions to incorporate possible countermeasures to enhance or sustain warfighter performance.