Summary. The aim of the study is to analyze and to substantiate alternative ways of solving problematic issues of medical evacuation of patients and casualties in conditions of temporary restriction of civil aviation flights. Materials and research methods. Materials of the study: practical experience of the specialists of the Center of sanitary aviation and emergency medical care of “Zashchita” Disaster Medicine Center of Federal Medical Biophysical Center named after A.I.Burnazyan of the Federal Medical and Biological Agency of Russia, as well as LLC “Medaero-Service”; statistical data on the field work of teams of the Center of sanitary aviation and emergency medical care on medical evacuation of patients from closed airspace areas; data from the official websites of the Federal Air Transport Agency, of Government and Ministry of Foreign Affairs of the Russian Federation, of Border Service, of Federal Tourism Agency, and assistance companies; electronic database of regulatory legal documents. Research methods: analytical, method of direct observation, comparison, description. Results of the study and their analysis. Results of the study, characterizing the problematic issues of medical evacuation of patients and victims in conditions of temporary restriction of civil aviation flights regime, are presented. The main ways of optimization of medical evacuation of patients and victims at the federal level during the period of air traffic limitation have been suggested and substantiated.