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Dating back to 3200 BC, military personnel routinely experience peripheral extremity wounds during combat. Traditionally, military anesthesia providers utilized general anesthesia and opioids to treat acute pain in the combat setting. Opioids can cause adverse effects such as respiratory depression, delirium, hemodynamic instability, nausea & vomiting, and addiction, which causes delays in care and requires more resources. Regional anesthesia is gaining favor during military operations due to its safety profile and effectiveness in controlling acute pain. Regional anesthesia is safer and more effective than opioids in the trauma/combat setting. Guidelines were provided based on current evidence in the literature and provided to guide anesthesia providers in combat. Implementing a regional training course for military anesthesia providers will instill confidence and provide guidelines for future and current providers in the combat setting. Medical carts in the operating room will reduce the time spent searching for equipment and maintain workflow during combat. Changing the current clinical practice will improve post-surgical recovery and ease of transportation for U.S. personnel serving in the combat setting.