A study in Australia over a decade ago highlighted the significant difference in CO₂ emissions between air ambulance and ground ambulance operations. While ground transportation emissions have been reduced through the adoption of electric and hybrid vehicles, the medical aviation sector is only beginning to address its emissions. Despite using similar aircraft to private jets, air ambulance operators face less criticism. The industry heavily relies on the private jet sector, and personnel often transition from private jet roles. Aircraft manufacturers have made noteworthy advancements, with helicopters now certified for sustainable aviation fuel use. Companies like Airbus and Leonardo are leading the way in utilizing biofuels to reduce emissions. However, challenges remain in transitioning to hydrogen and electric-powered aircraft due to technology limitations and infrastructure gaps. Sustainable aviation fuel offers a more immediate solution, already being tested by air ambulance operators like ADAC Luftrettung and DRF Luftrettung in Germany for reduced emissions and increased sustainability. While the industry shows positive progress, the road to widespread adoption of cleaner aircraft technologies presents significant hurdles.