The Assured Crew Return Vehicle (ACRV) system was conceived to meet the need for a means of return/rescue of the crew from the SSF in the event that the Space Shuttle became unavailable. This presentation will provide an overview of the development in the process and the philosophy of the ACRV.The ACRV program has four operational goals: simple, available, reliable, and affordable. The design goal is for the ACRV to perform as a lifeboat for a single mission event. It must be a dependable vehicle which can be operated by a wide range of personnel with limited training and proficiency. Return to either water or land landing are both under investigation. The effects of return a deconditioned crewmember with specific discussion of acceleration effects, transport logistics and medical aspects are also included.The development of medical guidelines for ACRV designs are challenging the medical community to address numerous issues related to long-term space exposure. Returning the crew safely, whether on a scheduled or unscheduled mission, requires continued definition and examination.