For adult motorcyclists with traumatic injuries in the Highlands, helicopter transfer appears to reduce transport times when the estimated journey to the trauma unit by land is greater than 77 minutes or approximately 49 miles. Patients injured closer to the hospital should be transferred by land to achieve an earlier arrival time. On-scene times were shorter for patients conveyed by land rather than helicopter, and the presence of a physician during the prehospital phase did not prolong on-scene time.