INTRODUCTION: Many countries have hypergravity training centers using centrifuges for pilots to cope with a high gravity (G) environment. The high G training carries potential risk for the development of spinal injury. However, no studies evaluated the influence of centrifuge training on the spines of asymptomatic fighter pilots on a large scale.METHODS: Study subjects were 991 male fighter pilots with high G training at one institution. Subject variables included information about physical characteristics, flight hours of pilots prior to the training, and G force exposure related factors during training. The two dependent variables were whether the pilots developed acute spinal injury after training and the severity of the injury (major/minor).RESULTS: The incidence of acute spinal injury after high G training was 2.3% (23 of 991 subjects). There were 19 subjects who developed minor injury and 4 subjects who developed a herniated intervertebral disc, which is considered a major injury. In multivariate analysis, only the magnitude of G force during training was significantly related to the development of acute spinal injury. However, there was no significant factor related to the severity of the injury.DISCUSSION: These results suggest that high G training could cause negative effects on fighter pilots' spines. The magnitude of G force during training seemed to be the most significant factor affecting the occurrence of acute spinal injury.Kang K-W, Shin YH, Kang S. Acute spinal injury after centrifuge training in asymptomatic fighter pilots. Aerosp Med Hum Perform. 2015; 86(4):386–391.