At approximately 06:15h on 16 April 2009, there was an explosion and subsequent fire onboard the Suspected Illegal Entry Vessel (SIEV) 36. The vessel was located in the vicinity of the Ashmore Reef, approximately 610 kilometers north of Broome in Western Australia (WA). Onboard were members of the Royal Australian Navy (RAN), 47 asylum seekers, and two crew members. Traveling with SIEV 36 were the RAN Patrol Boats, HMAS Childers, and HMAS Albany. The explosion resulted in five deaths and a large number of casualties with severe burn injuries, and a smaller number with concurrent trauma injuries. The Ashmore Reef incident was unique in that it involved the medical management and evacuation of 44 injured foreign nationals (31 seriously injured) in an extremely remote location. It resulted in an unprecedented health response from multiple agencies including local, regional, and state governments, commonwealth government agencies, non-government organizations, and private industry. The mission objective for this incident was to retrieve and evacuate multiple seriously injured casualties and stabilize them for safe transport to definitive care. The mission objective was achieved for the Ashmore Reef incident with no further deaths. As with all disasters, many lessons have been learned, and recommendations have been formulated. The logistic requirements to successfully complete such a mission have been reinforced as a result of this incident, as this was the most logistically challenging mass-casualty incident in WA history.