Aviation medical examination is closely related to flight safety. The purpose of the periodic physical examination is to prevent incapacitation in the cockpit with potentially disastrous consequences to life and property. Aerospace medical association of Korea has the authority to review aviation examination reports. The board of aviation medical examination can decide to the waiver or defer cases. They can make a medical decision based on the guidelines for aviation medical examiners, but the guidelines are not in detail. References of foreign country’s manuals of aviation medical examination such as International Civil Aviation Organization (ICAO), Joint Aviation Authority (JAA), and Federal Aviation Authority (FAA) are often utilized. The purpose of this study was to compare the aviation medical guidelines and the regulations in pilots with coronary heart disease of Korea and other countries. There was no significant difference between the Korean aviation medical manual and the others including ICAO, especially in the case of coronary heart disease.