INTRODUCTION: U.S. Army aviators are required to maintain a level of physiological fitness as part of their qualifying process, which suggests that they are generally physically healthy. However, it has not been statistically proven that they are more "physiologically fit" than the general population.METHODS: This retrospective study compares physiological measurements of U.S. Army aviators from the Aeromedical Electronic Resource Office database to the U.S. general population using the Center for Disease Control's National Health and Nutrition Examination Survey data. To enable an accurate comparison of physiological metrics between U.S. Army aviators and the U.S. general population, aviators were categorized into the same age groups and biological genders used for segmentation of the national population data.RESULTS: On average, pulse rate was 4.85 bpm lower in male aviators and 6.84 bpm lower in female aviators. Fasting glucose levels were, on average, 10.6 mg · dL-1 lower in aviators compared to the general population. Key metrics like pulse rate and fasting glucose were lower in aviators, indicating cardiovascular and metabolic advantages. However, parameters like cholesterol showed less consistent differences.DISCUSSION: While aviation physical demands and administrative policies selecting for elite physiological metrics produce improvements on some dimensions, a nuanced view accounting for the multitude of factors influencing an aviator's physiological fitness is still warranted. Implementing targeted health monitoring and maintenance programs based on assessments conducted more frequently than the current annual flight physical may optimize aviator safety and performance over the course of a career.D'Alessandro M, Mackie R, Wolf S, McGhee JS, Curry I. Physiological fitness of U.S. Army aviators compared to the U.S. general population. Aerosp Med Hum Perform. 2024; 95(4):175-186.