The FAA recently published a new advisory circular–AC 135-14B–to address operational procedures and equipment requirements for helicopter air ambulance (HAA) operators following an increase in fatal HAA accidents. The AC is addressed to existing and prospective Part 135 certificate holders planning to conduct HAA operations, their employees, employees of associated medical services, public service and governmental operators conducting air medical transport and to FAA Principal Inspectors with oversight responsibility for HAA certificate holders. Part 135 Subpart L addresses safety improvements for commercial helicopter operations through equipment requirements, pilot testing, alternate airports and increased weather minimums for all general aviation helicopter operations. This AC offers guidance through the application of best practices which, when tailored to local and operational requirements and the appropriate scope and complexity of each organization, provide one of many possible ways to ensure safety and compliance with regulatory requirements within an HAA operation. Many of these requirements also directly address recent National Transportation Safety Board (NTSB) safety recommendations.