Inherent to warfare, military commanders are regularly tasked with decisions that knowingly put servicemembers' lives at risk. Ensuring appropriate medical support for a mission in the event that one or many under their charge are injured is particularly challenging. Future combat operations introduce uncertainty into the mission planning process including developing an appropriate battlefield trauma system response. For the operational force, medical factors can become a “blind spot” for commanders without a medical background or knowledge of trauma care during attempts to mitigate the risk of injury and death. Many military leaders operate on the false assumption that the risk of death is low and acceptable if surgical care is provided within 60 minutes of injury, and the risk is high and not acceptable if the delay is longer than 60 minutes. The truth is that over-utilizing resources for low-risk operations may obligate limited assets needlessly and underutilizing resources for operations expected to be high-risk with significant injuries may squander the opportunity to prevent unneeded death. Therefore, it is in the commander’s best interest that planning is informed by data. Currently, however, injury data is not readily available to them, putting the commanders themselves at significant risk when making critical “life and death” or “go, no go” decisions. There exists a significant amount of evidence-based data that inform civilian trauma systems development which can be leveraged to inform future battlefield trauma system planning. It is imperative that both medical and operational leaders begin to utilize this data in order to remove the “blind spot” in command risk assessment and mitigation. As the threat of large-scale combat operations against near-peer adversaries becomes a reality, the need for data-driven medical support cannot be overstated. Battlefield trauma system planning will face challenges unseen in the last twenty years of sustained combat operations in Iraq and Afghanistan. Implications to the battlefield trauma system in LSCO include a lack of air superiority for aeromedical evacuation, large casualty volumes, and the need for far-forward damage control surgery. Both operational and medical leaders must be prepared to provide optimized medical support within the context of this new battlespace environment. To do this, we describe the PTRAM process, which acts as a relevant tool that bridges military planning and trauma care data. This new approach to “trauma systems science” involves identifying injury rates, estimating the number of casualties expected, determining baseline risk of death from injury, and applying targeted risk mitigations. It emphasizes data-informed decision-making as a necessary component of mission planning where commanders can better approximate optimized medical support and casualty care resources to the specific risks of each operational scenario. Refining the way commanders approach medical assets is of paramount importance, particularly within the context of large-scale combat operations where poor estimations compound numerically. Ultimately, the goal of this article is to provide an evidence-based method to assess the risk of death from injury and to apply precise mitigation strategies for any given operational scenario.