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In January 2010, the Tochigi Prefecture launched the Doctor Helicopter Services at Dokkyo Medical University Hospital. More than ten years have passed since the implementation of the service, and the total number of requests has exceeded 9,000 while the number of dispatches without any significant accidents has reached 8,000. We now report on the performance of Tochigi prefecture's "Doctor Helicopter." Based on the total number of helicopter operations compiled by the hospital, we surveyed the number of requests, dispatches, and un-dispatched cases; the number of requests from each fire department; the status of cooperation with neighboring prefectures; the medical institutions to which the helicopter is transported; and the classification by injury and disease. The number of requests and dispatches has increased each year of the operation. Un-dispatched cases owing to duplicate requests also increased along with the number of requests. Many of the requests were from the fire department in medical control areas. The number of cases in which Tochigi's Doctor Helicopter was dispatched to neighboring prefectures was much higher than the number of cases received by the neighboring prefectures from Tochigi. Endogenous diseases were more frequently encountered than exogenous diseases during the study period, with cerebrovascular disease accounting for the most significant proportion. Moreover, more than 50% of the patients were transported to the base hospital. Tochigi Prefecture Helicopter Emergency Medical Services are now indispensable for emergency medical care in the prefecture.