Watson Institute for International and Public Affairs
Costs of War

U.S. & Allied Wounded

As in every war, in Iraq and Afghanistan the wounded are far more numerous than those killed. Common combat injuries include second and third degree burns, broken bones, shrapnel wounds, brain injuries, spinal cord injuries, nerve damage, paralysis, loss of sight and hearing, post-traumatic stress disorder (PTSD), and limb loss.

The true count of Americans injured or sickened in the war is exponentially larger than the figures given on the official Department of Defense (DOD) casualty website. That official total includes only those “wounded in action.”

Not included are those suffering what are categorized as “non-hostile injuries” and other medical problems arising in theater, such as heat stroke, suicide attempts, respiratory problems, and vehicle crashes.

Other problems are not diagnosed until the injured return home. Toxic exposure from dust and burn pits and resulting respiratory, cardiac, and neurological disease represent another large segment of war zone-induced illness that has yet to be fully recognized.

Traumatic brain injury and PTSD are also major issues among Iraq and Afghanistan veterans. High rates of PTSD among U.S. veterans are alarming, but new evidence also suggests that military mental health providers use PTSD diagnoses to help returning soldiers receive assistance with a variety of problems they face reintegrating into their families and communities: joblessness and drug addictions among them.

All of this makes it difficult to estimate the number of those U.S. service members injured in the wars.

Key Findings

  • The official Department of Defense reports only a small fraction of those actually hurt in the combat zones – those wounded in action.
  • Many more injuries and illnesses have been publicly recognized post-combat than in theater.
  • Pentagon contractor injuries, especially of non-U.S. citizen employees, are significantly underreported.


  • The Pentagon and U.S. State Department should record and make public all deaths and injuries in the war zones, including those of U.S. troops, contractors (U.S. and foreign citizens), civilians, and opposition fighters.
  • The Pentagon and U.S. State Department should periodically assess the incidence and prevalence of war-related mental and physical disabilities that arise following discharge from the military.

(Page updated as of July 2021)