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During long combat missions in fighter aircraft, passive in-flight fatigue countermeasures are often not feasible. As a result, stimulant medications (Go Pills) may be used in-flight. The present study attempts to describe the individual decision factors influencing stimulant use during combat operations. Methods: 35 deployed F-15E aircrews participated in this study. Prior to the deployment, interviews were conducted to identify factors influencing the inflight decision to use stimulants. Based on this qualitative information, a novel survey instrument was developed. Results: Surveys were completed after 111 sorties. Results were summarized graphically. Conclusions: Active and anticipated in-flight fatigue were the most common decision factors across all groups. Leadership influence and perceived repercussions were the least influential. Previous Go Pill experiences and in-flight performance were more influential among sorties using stimulants (p<0.001). There were no notible differences in decision factors across deployment experience.