In active combat zones medications may not be stored in an environment where the temperature can be highly regulated. Medications may be exposed to extreme temperatures and the effect on stability could be profound in combat zones. In these areas, over a course of a year temperature can vary from 0 deg C 32 deg F to 40 deg C 105 deg F or even higher. There is no data on such large temperature fluctuations and how that may affect drug stability. This study will provide stability data in these extreme temperature ranges for the most commonly used analgesic by the military, ketamine. This study included three research objectives. 1 Evaluate the stability of ketamine in a simulated environment where large temperature fluctuations can be seen. This will be done by comparing the difference in measured and labeled medication concentrations after 1 to 6 months of exposure. 2 Evaluate the stability of ketamine on active EMS units in Cincinnati, OH during the summer months. This will be done by comparing the difference in measured and labeled medication concentrations after 1 to 6 months of exposure. Results In this study, despite exposure to extreme temperatures, all ketamine samples reflected minimal degradation. Ketamine concentrations were maintained at greater than or equal to 95 percent of the labeled concentration despite being exposed to extreme temperature environments. Conclusion The ketamine samples in this study exhibited limited degradation when exposed to fluctuating extreme temperature environments. Although it is recommended to store ketamine at the temperatures specified by the manufacturer, this study does demonstrate that ketamine did not undergo significant degradation when exposed to high temperature environments. Further studies are required to validate these results.