Abstract: Objective To provide the theoretical basis for aerospace medical support by analyzing the characteristics and evolution rules of disease spectrum in pilots admitted to our hospital from 2003 to 2012. Methods The major diseases and their evolution rules in 1 228 pilots admitted to our hospital from 2003 to 2012 were analyzed by reviewing their medical histories. Clinical data about these pilots flying different types of aircrafts were compared. Results The top 10 diseases in pilots were cervical lumbar diseases, hypertension, gastroenteritis, fatty liver, respiratory infections, urinary stones, hyperlipidemia, headache, sleep disorder, gallbladder polyps, mainly involving departments of gastroenterology, orthopedics, urinary surgery, neurology and cardiology. The incidence of fatty liver, hyperlipidemia, hyperuricemia, respiratory infections was significantly higher whereas that of hypertension, headache, sleep disorder, prostatitis was significantly lower in recent 5 years than in 5 years ago (P< 0.05). The incidence of fatty liver and respiratory infection was significantly higher in helicopter pilots than in those flying other types of aircrafts (P< 0.05). The incidence of hypertension was higher in transport aircraft pilots than in those flying other types of aircrafts (P< 0.05). The incidence of cervical lumbar diseases was significantly higher in fighter pilots than in non-fighter pilots (P< 0.05). The incidence of hyperuricemia and gastroenteritis was significantly different in pilots flying different types of aircrafts (P< 0.05). Conclusion Cervical lumbar disease, hypertension, gastroenteritis, fatty liver, etc, are most frequently encountered in pilots and vary with time. The spectrum of high incident diseases is different in pilots flying different types of aircrafts and measures should be taken for prevention and treatment of these diseases.