Brooks CJ, MacDonald CV, Gibbs PNA. Injury rate in a Helicopter Underwater Escape Trainer (HUET) from 2005–2012. Aviat Space Environ Med 2014; 85:857–62. Background: Helicopter underwater escape training (HUET) carries a potential for injury and this paper identifies the injury rate. Method: A marine survival training school registry of all students trained between 2005–2012 in HUET and the coinciding accident records were examined. Results: There were 8902 students trained in a helicopter underwater escape simulator for a total of 59,245 underwater escapes. There were 40 cases where only first-aid was required and 3 serious injuries (a laceration requiring 5 sutures, 1 dislocated shoulder, and 1 water aspiration requiring hospitalization). There were no deaths and no problems reported with using the Emergency Breathing System (EBS) or Air Pocket. Of the injuries, 11 were due to the student using a poor escape technique. The overall probability of injury was 0.74 per 1000 ascents. Conclusions: In HUET training, there is a very low injury rate with almost no significant severity. Although not scientifically proven, this would suggest that the low incident rate is due to good medical screening and the attention given by instructors to anxious students. Compared to other training such as diving, parachute jumping, and submarine escape training, the rate of injury was considerably lower.