Although they have many strengths, including high intelligence and extraordinary physical and mental toughness, many members of the military special operation forces (SOFs) face a number of medical, emotional, and social problems that are not adequately captured by psychiatric diagnoses of depression or PTSD.  Our naturalistic, observational report identifies a set of healthcare difficulties within the SOF community that represent a common pattern of interrelated medical, psychological, and social impairments in this unique group. They include traumatic brain injury (TBI); endocrine dysfunction; sleep disturbance; obstructive sleep apnea; chronic joint/back pain, orthopedic problems, and headaches; substance abuse; depression and suicide; PTSD; anger; worry, rumination, and stress reactivity; marital, family, and community dysfunction; problems with sexual health and intimacy; being “on guard” or hypervigilant; memory, concentration, and cognitive impairments; vestibular and vision impairments; challenges of the transition from military to civilian life; and existential issues. This unique constellation of medical and behavioral healthcare needs may be understood as the natural consequence of an extraordinarily high allostatic load: the accumulation of physiological, neural, and neuroendocrine responses resulting from the prolonged chronic stress and physical demands of a career with the military special forces.