This is a study of the medical logistics system that supported the U.S. forces in the maneuver phase of the Iraq War, 20 March to 1 May 2003. It begins with a review of logistical lessons learned from retired logisticians stretching from World War II to the Gulf War with an emphasis on the challenges in building a logistical support system in a new theater of operations. Next, the evolution of U.S. Army medical logistics is reviewed leading up to the units, policies, and resources available to support the Iraq War. The creation of the medical logistical support system in Qatar and Kuwait is then described, stretching from the initial site selection for the regional medical logistical warehouse in the summer of 2002 through the execution of medical logistical support in the maneuver phase of the ground war in the spring of 2003. Finally, an evaluation of the performance of the medical logistic support, utilizing the lessons learned discussed earlier, is presented with recommendations for improved performance in the future. This study concludes that the medical logistics support system was not functioning properly when the ground war began on 20 March 2003. Several factors contributed to the medical logistics problems, including garrison procedures not simulating field procedures, weak communications and a lack of infrastructure in Kuwait, but the late arrival of medical logistics units into Kuwait was the main reason for the poor performance of medical logistics in the Iraq War. While the medical community had been deeply involved in planning for the deployment, the decision by the Department of Defense to discard the Time Phased Force Deployment List in favor of a Force Package approach meant that many critical logistical units were pushed to the end of the deployment cycle. Instead of two medical logistical battalions and one medical logistical company supporting the Vth Corps units in Kuwait and Iraq, only the medical logistical company was present during the Reception, Staging, Onward Movement, and Integration phase and functioning during the opening weeks of the ground campaign. Since the medical logistics system was not functioning properly during the drive to Baghdad, the combat health support system was not capable of treating heavy casualties had they been encountered.