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Background. Evidence does not support the prehospital use of mechanical chest compression devices. Nevertheless, in certain patients their use might be indicated. Methods. Therefore, on the basis of the existing literature indications for the prehospital use of mechanical chest compression devices are presented and discussed with particular focus on air rescue service. Results. Three scenarioswhere the use of mechanical chest compression devices is indicated could be identified. These are cardiopulmonary resuscitation in the alpine terrain, resuscitation of patients with accidental hypothermia and of avalanche victims, and resuscitation during airborne transport. Advantages and disadvantages of the two chest compression devices on the market (LUCAS and Autopulse) are discussed with regard to air rescue service.