Older people and those with chronic illnesses are travelling overseas more than ever before. Basic but important considerations are adequate supplies of medication (carried in the hand luggage), a health summary and medication list. Travel is associated with increased risk of deep venous thrombosis. Exercises can be advised, but evidence is currently lacking on the benefit of aspirin or low molecular weight heparin for prophylaxis. In assessing lung disease and cardiac disease exercise tolerance is a guide to the patient's fitness for air travel. Vaccinations are important but care is needed when giving live vaccines to immunocompromised patients.