In the 2 years since the DHS was created, approximately $4 billion has been funneled into DHS's health-related components dealing with issues of military medicine and safety tools for first responders whose job it is to run straight into catastrophes. The Homeland Defense Journal organized a conference in Maryland, in which professionals gathered to discuss new medical and homeland defense products, government contracts, and procurement and logistic processes. Key developments in medical disaster preparedness at the U.S. Army Medical Research and Material Command (USAMRMC) in Ft. Detrick, MD, are reviewed, followed by an account of innovative hardware solutions for homeland security that are being developed in the private sector. The Reeves Group out of Frederick, MD, is one of the main contractors serving the first responder and military communities and is responsible for the development of such products as decontamination tents and advanced biohazard attire. The U.S. Army's Telemedicine and Advanced Technology Research Center (TATRC) has built cooperative relationships in order to revise civilian technology to meet military needs. The remaining challenges to military medicine include the revision of existing medical response models that are based on "naturally epidemiological occurring event," rather than on a model based on terrorist attack scenarios. Other challenges include a low level of domestic preparedness among States driven, in part, by bureaucratic inertia. In an effort to keep America safe, "the country's medical guards, like all others, must stay up."