Medical examinations for aircrew (MEA) have been applied in various extents since World War I, when medical fitness of aircrew began to be spotlighted as a major factor of flight safety and flight performance. The main purpose of MEA is to identify any presumptive medical defects that may cause sudden incapacitation and aircraft accident consequently. However, the value of medical screening tests has been debated for many years and raised questions of their effectiveness and aeromedical usefulness. Therefore, this review article focuses on diverse perspectives regarding MEA and tries to develop the most appropriate way of implementing medical examinations for insuring flight safety.