As Operation Iraqi Freedom enters its third year, the multinational military force remains engaged in a complex mission based on the military and political climate in the Middle East. As US Navy cardiologists deployed to Kuwait, our experiences proved diverse as we learned to practice in an austere environment. From the evaluation of chest pain to the treatment of coronary artery disease and arrhythmia, patient care was tempered by our ability to use our clinical acumen, physical exam and basic objective data to establish definitive dispositions. Given our younger patient population, involvement in primary prevention efforts was a large focus, allowing us to gain a new perspective on the role of the subspecialist in changing patients’ mindsets and lifestyles. By combining the basic tenets of our cardiology training with the practical aspects of diagnosing and treating in a war zone, we developed a great respect for the management of cardiac patients under challenging and often limited conditions. Our experiences as cardiologists in the desert were truly diverse and encompassed virtually every aspect of cardiovascular medicine, involving both current and historic treatment perspectives. Many unique, lifelong lessons were learned.