A comprehensive selection examination in the Republic of Singapore Air Force (RSAF) aims to minimise medical wastage of military pilots who have to function safely in the unnatural environment. Of the 8642 applicants examined, 657 (7.6%) were rejected for non-medical reasons before completion of medical examination. Of the remaining 7778, 58.7% passed the selection examination while 41.3% failed. Ophthalmological (34.3%), anthropometry (23.7%), and ENT (13.7%) conditions were the three major causes for failure (71.7%). Myopia and astigmatism accounted for 57.6% while squints accounted for 22.1% of the ophthalmological conditions. Amongst ENT conditions, 70.8% were for marked vasomotor rhinitis, sinusitis and nasal septum deviation with marked narrowing of one or both nasal passages, while 22.4% were for permanent abnormal hearing threshold shifts above the minimum standards.