To understand the history of the Joint Trauma System (JTS) one must first review its roots in civilian trauma systems and its immediate predecessor, the Joint Theater Trauma System (JTTS). The common origin of both the JTS and the JTTS was the need to support war surgery and, more specifically, what has been broadly termed “combat casualty care.” All trauma systems, whether military or civilian, integrate and optimize resources along the spectrum of care from prevention to acute care to rehabilitation as well as the right-sizing capacity to deliver the right patient to the right place to receive the right care at the right time—the end goal of this process is reducing preventable death and disability.