A gentleman aged 55 met with an accident, when his two wheeler was hit by a train on 30/06/2015 at Jharkhand and had sustained chest, back and unstable pelvic injuries. Initially treated at Apollo Hospitals, Kolkata with a chest tube inserted on the right chest on 03/07/2015, he had to be transferred to Apollo Hospitals, Chennai for definitive care and treatment. His chest injuries resuscitated that he needed oxygen support. An expert medical escort team comprising of a Senior EM Clinician and an efficient Paramedic, took the challenge to transfer this patient by train. He was oxygen dependant and required continuous monitoring, IV Fluids and the transfer took 36 hours by train. The transfer was more and more complex for the fact that he had chest tubes in Situ and a grossly unstable pelvic fracture. He was received at our hospital on 08/07/2015 under the care of our Senior Orthopedician Dr.Balaji Srinivasan. The patient underwent surgery and operatively got his bones fixed. He was discharged in three days and is now able to walk on his own with support.