Proton exchange membrane fuel cells (PEMFC) not only offer more efficient electrical energy conversion, relative to on-ground/backup turbines but generate by-products useful in aircraft such as heat for ice prevention, deoxygenated air for fire retardation and drinkable water for use on-board. Consequently, several projects (e.g. DLR-H2 Antares and RAPID2000) have successfully tested PEMFC-powered auxiliary unit (APU) for manned/unmanned aircraft. Despite the progress from flying PEMFC-powered small aircraft with 20 kW power output as high as 1 000 m at 100 km/h to 33 kW at 2 558 m, 176 km/h [1-3], durability and reliability remain key challenges. This review reports on the inadequate understanding of behaviour of PEMFC under aeronautic conditions and the lack of predictive methods conducive for aircraft that provide real-time information on the State of Health of PEMFCs. Highlights: The main research findings are -To minimize performance loss due to high altitude and inclination by adjusting cathode stoichiometric ratio. -To improve quality of oxygen-depleted air by controlling operating temperature and stoichiometric ratio. -Need to devise real time prediction methods conducive for determining PEMFC SoH in aircraft.