This new ABC title will provide a stepwise approach to clinical assessment, management options, decision making in complex and ethically challenging situations, teamwork, cultural sensitivities and logistics. It also addresses the safety, mental health and psychological impact on healthcare professionals working within the field. The title draws upon the experiences of the editor and a wide range of contributors from working in the field. It includes case examples, and practical guidance and methods on how to approach often overwhelming situations. The title begins with an overview of emergency medicine in austere environments and addresses safety and security issues, cultural and language considerations, and the availability of resources in such settings. The next six chapters provide an overview of common trauma injuries and how to overcome the practical challenges of providing immediate and on-going care for trauma patients. Particular clinical and logistical problems in austere environments include anaesthesia, obstetric care and patient transfer which are covered in their own chapters. A chapter on envenomation provides guidance on a relatively uncommon topic within the practice of medicine in developed countries. Working in austere environments can provide opportunities for professional development in improving clinical acumen and decision making, and developing a wider range of transferrable skills, which is addressed within two chapters. The title concludes with a chapter on the importance of practical self-care and individual welfare, both in the field and upon returning to the practice of medicine at home.