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Human activity in microgravity environments place flight crews at risk to injury that may require surgical triage and care. Current protocols developed to handle surgical care in microgravity are derived from earth based wound care techniques. Fluid and debris containment, spacecraft environmental contamination and expediency of wound care in microgravity remain as significant obstacles. For space based surgery, lasers may allow procedures for rapid stabilization of emergency or traumatic injuries, surgical fluid control, hemostasis and reduce contamination of the aircraft environment. The purpose of this paper is to outline the basic concept of laser surgery in an aviation and microgravity environment using carbon dioxide, neodymium yttrium aluminum garnet (ND:YAG), KTP and Excimer laser incisions within high altitude, military, aviation and microgravity aviation environments.