The United States and its allies in the Persian Gulf War (PGW) knew that Iraq had used nerve agents and chemical weapons in its previous conflicts and so took steps to protect their troops. Pyridostigmine bromide (PB) was distributed as a pretreatment that would enhance the effectiveness of postexposure treatments in the event that the nerve agent soman was used. This report examines the role that PB played in the ongoing chronic health problems documented in PGW veterans. After careful examination of the known effects of PB on the central and peripheral nervous systems, the author finds the evidence consistent with a possible role for PB as a contributor to the health complaints of some PGW veterans and calls for immediate attention in the form of additional investigation to clarify the role of PB.