Pilot mental disorders are important risk factors of aviation accidents. It is not easy for an aviation medical examiner to diagnose pilot mental disorders and take appropriate measures. Pilots that have mental disorders tend to underreport or falsify their medical history, especially with regards to any mental disorders they have. They do so, so that they can obtain the aviation medical certificates that enable them to fly. This type of diagnosis is not the role of an aviation medical examiner, but the role of an expert psychiatric specialist. This article explains the aeromedical concerns and the prevalence rate of pilot mental disorders, a pilot depression case, and the basic knowledge and precautions of an aviation medical examination.