We will present key recommendations from lessons learned during a group review of historical accounts of medical and surgical practice in guerrilla and austere environments. The goal of this presentation is to provide leaders with a framework to prepare for future IW operations. Specifically, we will emphasize appropriate medical education and training for the IW campaign, advocacy for policy change, embracing alternative practices, and mentoring resilient healthcare providers. Organizing our recommendations into a DOTMLPF framework, we seek to inform key opinion leaders, stakeholders, and medical providers of the relevant historical lessons and their importance for future operational planning. We will emphasize the tactical considerations of extremely restricted logistics as well as the extended evacuation times and distances expected in future conflicts. Finally, we will discuss the exceptionally challenging moral and ethical decisions facing providers in such limited-resource environments with an emphasis on preventing moral injury to providers.