Tactical medicine has evolved significantly in the last several decades and is not simply transferring traditional trauma care into a law enforcement or military environment. Medical care in the tactical environment is driven by environmental constraints and requires an understanding of evidence from conflict-related injury research. The training required to safely provide tactical medicine is broad and multifaceted. This chapter reviews the history of tactical medicine in military and law enforcement contexts and explores specific interventions, approached in an algorithmic fashion that must be tailored to the incidence of injury and tactical environments.