Inside Pararescue: The Elite Airmen Behind The Rescue in Iran

Pararescuemen of the United States Air Force, known as PJs, stand as the only Department of War specialty specifically organized, trained, and equipped to conduct full-spectrum 

personnel recovery operations. These battlefield airmen handle both conventional and unconventional combat search and rescue 

missions while delivering emergency medical care in any environment around the globe. Their motto, "These things we do that others may live," reflects a commitment to self-sacrifice in service of saving others, whether the mission involves downed aircrews, isolated personnel, or civilians caught in disasters. They are called PJs because the initials originally stood for Parachutist and Diver (or "Para Jumper") as listed on early Air Force flight forms to identify personnel who would jump from aircraft.

The history of Pararescue traces back to WWII. In August 1943 a C-46 transport aircraft crashed in a remote jungle near the China-Burma border, leaving survivors stranded in dense terrain reachable only by paradrop. Lieutenant Colonel Don Flickinger and 2 medics volunteered to jump in, providing aid and helping extract the wounded with local assistance over the following month. This early effort highlighted the need for specialized teams. By 1946 the Army Air Forces created the Air Rescue Service, and in 1947 Pararescue jumpers were officially included. The occupation specialty received formal approval the following year. Over the decades PJs evolved from basic survival and medical roles into elite special operators capable of operating in denied areas. 

Today PJs fall primarily under Air Force Special Operations Command and Air Combat Command. They integrate with joint special operations forces and often embed with units like Army Rangers or Navy SEAL teams to provide immediate trauma care and recovery support. Their versatility allows deployment via air, land, or sea tactics, including high-altitude high-opening parachute jumps, combat diving, helicopter insertions, and ground infiltrations. In humanitarian roles they have supported NASA spacecraft recoveries after water landings and responded to natural disasters worldwide.

The training pipeline to become a PJ ranks among the longest and most demanding in the U.S. military. It spans nearly 2 years and features one of the highest attrition rates, typically between 75 and 95% depending on the class and era, with many candidates washing out during early assessment and selection or the combat dive phase. 

Candidates begin with basic military training followed by special warfare preparatory courses, assessment and selection, pre-dive training, and then a sequence of specialized schools. These include Army Airborne School for static-line parachuting, combat dive training at Naval Support Activity Panama City, military free-fall parachutist school, survival evasion 

resistance and escape (SERE) training, the special operations combat medic course leading to paramedic certification, and the Pararescue recovery specialist or apprentice course. Trainees master skills in advanced parachuting, scuba diving, rock climbing, mountaineering, arctic operations, small-unit tactics, field medicine, and tactical combat casualty care. Throughout their careers PJs maintain paramedic qualifications and continually refine these abilities through advanced courses such as the combat leader course. After initial qualification many proceed to mission qualification training at units like the 68th Rescue Squadron, which serves as a formal training unit for high-end operations.

What PJs do extends far beyond simple extraction. They locate, authenticate, treat, stabilize, and evacuate injured personnel under fire or in extreme conditions. As advanced-scope paramedics they perform procedures such as tourniquet application, wound packing, cricothyrotomies (an emergency surgical procedure to create a temporary airway directly into the trachea), chest tube insertion, and blood product transfusions while operating in hostile environments. Their medical expertise combined with special operations tactics makes them unique trauma specialists with rifles. In combat they provide the essential surface-to-air link in personnel recovery, often serving as the difference between life and death for isolated service members. About 40% of PJs operate in special operations command roles with additional training to support teammates in Navy SEAL or Army Special Forces units.

Since the September 11, 2001 attacks these elite warriors have executed over 12,000 life-saving combat rescue missions. In the same period they have rescued thousands of civilians during catastrophic natural disasters and other humanitarian responses. PJs represent the most highly decorated enlisted force in the Air Force, with one Medal of Honor, 12 Air Force Crosses, and more than 105 Silver Stars awarded for heroism. Of the roughly 22 enlisted Air Force Cross recipients historically, 12 have been PJs. During the Vietnam War 19 PJs were killed in action, and 10 of the 19 Air Force Crosses awarded for Pararescue actions in that conflict went to them. In the wars in Iraq and Afghanistan 16 PJs or combat rescue officers have been killed in action, with an additional 53 PJs dying in the line of duty from training accidents and other mission-related incidents. Their overall record includes participation in thousands of missions where survival rates for patients reached by PJs have been exceptionally high, often exceeding 97% in documented trauma encounters.

Interesting aspects of the PJ community highlight their distinct culture and capabilities. They earn the right to wear the maroon beret, a symbol of their elite status. The green feet tattoo, traditionally inked on those who complete combat dive school, serves as a quiet badge of honor within the community. PJs maintain constant readiness for missions that can unfold anywhere from remote mountain ridges to open ocean or urban battlefields. Their role in supporting other special operations elements means they often train alongside the most elite units while focusing on the save rather than the strike. Equipment includes state-of-the-art medical kits, advanced parachutes, diving gear, climbing rigs, and weapons tailored for both medical extraction and self-defense in hostile territory. They have adapted to modern threats, including exercises simulating near-peer conflicts with contested airspace, missile strikes, and limited supplies. PJs continue to adapt to evolving challenges in complex humanitarian crises and high-intensity combat. Squadrons like the 68th Rescue Squadron prepare new PJs through mission qualification and leadership courses. Their work remains classified in many cases, yet public accounts of daring rescues reveal the extraordinary risks they accept daily. Their legacy of saving lives at any cost ensures that when American or allied forces face isolation or injury, the call goes out to those who live by the creed that others may live.