Background: In response to an Air Force leadership request, this evaluation details the development, implementation, and evaluation of a military-unique neonatal air transport course following its inaugural offering in October 2024. Between October 2023 and May 2024, we conducted a needs assessment and then developed a 5-day neonatal air transport course. The curriculum included military transport logistics, ethics, equipment training, altitude and transport physiology (including an altitude chamber flight), emergency procedural skills, and a transport simulations. Many of these topics were previously omitted or inconsistently covered despite their inclusion in national neonatal transport training standards. The evaluation questions were: 1) How much did knowledge improve? 2) How are changes in learner confidence scores explained by their experiences with neonatal transport and transport training before and after the course? 3) How do learners feel the course can be improved? Methods: Using an explanatory sequential mixed methods design, participants completed pre- and post-course knowledge assessments and a 7-item confidence survey (Likert scale 1-10) developed by the evaluation team. Knowledge and confidence assessments were repeated three months post-course and followed up with an interview ,which was guided by early findings from the knowledge and confidence assessments (analyzed using descriptive statistics). Interviews were coded independently by the three team members and refined based on consensus. Subsequent confidence and knowledge assessments were compared using T-tests. Integration of quantitative and qualitative strands relied on “following a thread” and a joint table display to create meta-themes. Results: The course included three physicians, two nurses, and three respiratory therapists from three military neonatal transport sites and one civilian fellowship program. Knowledge assessment scores improved from 47% to 78% (p<0.01). Aggregate confidence assessment scores improved from 4.5 to 7.8 (p<0.01). However, three months after the course, knowledge assessment scores decreased from 78%to 63% and aggregate confidence decreased from 7.8 to 7.4. Meta-themes from the integrated analysis included; a) limited prior training and experience among transport course attendees (even among those who were doing transports), improved equipment training, improved training in transport planning, and the need for skills sustainment and reference materials to help maintain transport knowledge and confidence. Conclusion: Development of this standardized neonatal air transport course resulted in significant improvements in knowledge and provider confidence in neonatal transport-related areas; especially in transport equipment training, transport logistics and planning. Three months after the course, a slight decline in knowledge and confidence was noted. The findings also point to a need for continuous review and training for skills sustainment, especially in the context of infrequent transport opportunities that might otherwise help maintain gains established by the course. Limitations of this study were a small sample size and yet to occur psychometric evaluation of the transport knowledge and confidence scales.