Objective: The objective of this final work is to show the work and the results of the Helicopter Emergency Medical Service HEMS, which took place as part of the Pilot project of the Ministry of Health and compare them with the current way of working in an emergency medical helicopter transport. Methods: The study was conducted by retrospective analysis of data from the Pilot project HEMS, from 09 September 2015. do 9 January 2016. Data were taken from the Croatian Institute for Emergency Medical Services, with the approval of the Director Maja Grba - Bujević. Results: From 9 September 2015 to 9 January 2016, was preformed 229 interventions. From the base on the island Krk was carried out 104 interventions, 102 interventions on islands, and 2 interventions on land. 102 interventions were in Primorsko - goranska county and 2 in Zadar county. From the base on the island Brač carried out 125 interventions, 89 intervention on islands and 36 intervention on land. 80 intervention was in Splitsko-dalmatinska county, 44 in Dubrovačko - neretvanska county and one in Šibensko – kninska county. Helicopter medical teams most often intervened in case of heart patients (69), patients with trauma (47), patients with stroke (17), emergency management of pregnant women (14), emergencies in children (14) and other emergencies (68). In the same period, military helicopters were carried out 64 emergency medical transportation. Flight price per hour in the Pilot project was significantly lower than the cost of a military helicopter, and the intervention time shorter than during the intervention of the military helicopter. HEMS transported all patients within the „golden hour“. The primary flight was preformed for the first time in the Republic of Croatia. Conclusion: The Pilot project has shown justification, cost effectiveness and the need to introduce HEMS in an integrated system of emergency medical services in the Republic of Croatia. This would more effectively provide emergency medical care and linking primary health care in isolated areas with secondary and tertiary health care. Establishment of HEMS can have a positive demographic effect on the population s of our islands and rural areas and have a positive impact on the tourist offer of the Croatian. Also, the primary task of the military helicopter should not be patient transport and rescue, except in cases of major accidents and disasters.