World perceptions of security and health threats have changed in the last decade. The terrorist attacks of September 11, 2001 ushered communities into a new paradigm of social construct and behavior. In the United States (U.S.) the heightened security measures, surveillance, and medical preparedness of the Patriot Act have had far reaching effects on various sectors of our society. Fortunately, there has not been a successful attack on U.S. soil since 9-11, but our allies in the “war on terror” have not been so fortunate (e.g. London, Madrid, Mumbai and Oslo bombings). Changes in the scope of civilian and military involvement and an expanding medical role are discussed.