In this chapter, we explore the decision-making processes of ICs and their management of external and internal stressors. As ICs bear the immense responsibility of making life-and-death decisions, understanding how stress influences their judgment is critical to comprehending the nature of incident command work. Using qualitative interviews, survey data, and preliminary psychophysiological evidence, we examine the biological risks posed by chronic occupational stress in this field. Stress-related impacts on cognitive and physical responses are shown to affect decision outcomes significantly. Drawing on these findings, we offer recommendations to enhance police training, emphasizing strategies to mitigate the adverse effects of stress and improve decision-making during high-stakes incidents.