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Abstract: Introduction: Helicopter emergency medical services play a valuable role in the transfer of critically ill patients. This paper reviews the role of air ambulance services in the provision of regional burns care and suggests guidelines for their use. Methods: A retrospective review of patients treated at the Midlands Adult Burns Centre over a 3-year period. Results: 27 adult burns patients were transported by air ambulance during the study period. Patients were aged 19–89 years (average 41.3 years) with an estimated burn size of 5–70% TBSA. Distance travelled was 11–79miles (average 41.2miles). All patients were appropriately referred to the burns centre according to national referral guidelines but in 7 cases (26%) it was felt that transport by air ambulance was not clinically indicated and land transfer would have been safe and appropriate. Conclusion: Air ambulances offer a fast and effective means of transferring patients to a regional burns centre in selected cases. There is limited data for the beneficial effects of helicopters and survival benefit is seen only in the most severely injured patients. We suggest criteria for the use of air ambulances in burns patients in order to maximise the benefit and reduce unnecessary flights. [Copyright &y& Elsevier]