Forward Surgical Teams (FSTs) are 20-person units designed to perform front-line, life-saving combat surgery. This study compares the employment, injuries encountered, and workload of an airborne FST in two widely varying campaigns. The 250th FST provided far forward surgery for initial entry assaults and follow-on stability operations in Afghanistan (Operation Enduring Freedom [OEF]) and northern Iraq (Operation Iraqi Freedom [OIF]). Prospective data on all patients admitted to the 250th were analyzed. Data from civil affairs missions were evaluated retrospectively. In supporting combat operations, 127 surgical procedures (OEF: 68, OIF: 59) were performed on 98 patients (OEF: 50, OIF: 48) during 17 months deployed (OEF: 6, OIF: 11). After initial assaults, stability actions varied significantly in terms of civil affairs missions (OEF: 3, OIF: 161). Although the number and types of combat casualties were similar between the campaigns, employment of the FST changed dramatically in OIF because of increased medical reconstruction missions.