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PurposeThis paper's aim is to study North African refugees admitted to Sicilian hospitals from Lampedusa by helicopter emergency service 118, from 1 January to 22 September 2011 when due to a violent uprising in the Refugee Centre, Lampedusa is no longer accepting refugees by order of the Ministry of Interior.Design/methodology/approachThose migrants who were in need of hospitalization were transferred to the Sicilian hospitals exclusively by the emergency helicopter service 118. All 203 patients were classified according to the admission diagnosis reported on medical records of 118 and data were aggregated according to: disease, sex and department in which hospitalization was required.FindingsWomen were admitted to hospital almost exclusively for obstetrics and gynecological problems, while men for trauma, severe dehydration, attempted suicide, infectious diseases (TB, airways distress, and scabies), seizures and metabolic diseases. Hospitalization rate was 20 times lower in African migrants than Italian population compared per age and sex, confirming “the healthy immigrant effect”.Originality/valueThe paper shows that identification of health problems requires a careful monitoring that has implications for diseases dissemination (i.e. TB, HIV) both for ill patients who arrive, either for prophylaxis of healthy migrants, pursuing a valid vaccination policy. Maximum use must be made of the moment of the arrival of migrants to get and disseminate health information.