Aircraft disinsection has been an international practice since the 1920s, the purpose of which is to protect public health, the environment, agriculture, and livestock by the eradication of disease vectors. Although most nations of the world have discontinued this practice, about 20 continue with this requirement. Aircraft disinsection is sanctioned by international law with the World Health Organization (WHO) publishing general procedural guidelines in the International Health Regulations (IHR). There are currently four acceptable procedures: blocks away, top of descent, on arrival, and residual. A 2% pyrethrum solution, a naturally occurring substance found in the chrysanthemum flower, or several synthetic pyrethroids, are the recommended agents because they are extremely effective insecticides which pose minimal health risks. Although the use of insecticides for aircraft disinsection is controversial, national policies compelling this requirement must be respected. This paper will explore the background of aircraft disinsection, the procedures, the types of agents, and the toxicity. If aircraft disinsection is regulatory policy, it should be done in accordance with WHO procedures. Residual application is probably the most efficacious method. The use of air curtains or plastic strips should be explored as an alternative to the use of chemicals.