On the evening of February 25, 1991, an Iraqi scud missile plunged into a "barracks/warehouse" used to house U.S. Army soldiers assigned to the 475th Quartermaster Group in Dhahran, Saudi Arabia. As a consequence of this scud attack, 28 soldiers died, 110 were hospitalized, and 150 experienced minor physical injuries and/or subsequent mental health problems. This one scud's impact accounted for more than one-third of all U.S. soldiers killed during the war. Fortunately, there were very few "models" of mass casualty experiences during the Persian Gulf War to evaluate the critical clinical outcomes to the soldiers. An analysis of this event has important implications for future military operations that feature a multinational medical force structure. This article summarizes the medical preparations before the war, the key, chronological events, and the medical outcomes of the mass casualty event. Lessons learned in casualty management for future Army contingency medical planners are identified.