Introduction: Troops deployed to Iraq and Afghanistan are at high risk for exposure to combat events. The occurrence of Posttraumatic Stress Disorder (PTSD) and Traumatic Brain Injuries (TBI) or concussion related to these events is of interest. In the last two decades much interest has been given to the prevalence of PTSD in returning soldiers. The Dutch deployment in Uruzgan was also characterized by the frequent occurrence of blasts caused by improvised explosive devices (IEDs). A timely and proper assessment of the impact of an IED blast is necessary for the health and sustainability of military personnel during missions. OBJECTIVE: We designed and implemented a protocol for the assessment of comorbid PTSD or depression and long term follow-up of soldiers who were exposed to blast of IED. Method: From November 2009 to August 2010 all Dutch soldiers who were exposed (during deployment in Afghanistan) to a blast from IED or grenades within 25 meters were assessed with the Military Acute Concussion Evaluation (MACE, McCrea, 2001)). This was performed within 24 hours (T1) in theatre, by a specially trained nurse or doctor. Three to six months after their return (T2) home this group of non-injured soldiers (n=106) was invited to be reassessed by a series of self-report and clinical instruments. After the test a clinical interview was performed with a clinical neuropsychologist to assess PTSD or depression. Concurrent treatment in hospital or in the outpatient department was not influenced and if necessary, the patient was referred to the psychiatrist for PTSD, rehabilitation center or other specialist for medical problems. RESULTS: In the acute phase, MACE was helpful to structure the assessment. Immediate in-theatre assessment will prevent retrospective bias when asked about event-related aspects later. Preliminary results of all MACE assessment on T1 (n=98), as well as the detailed follow-up assessment (T2) in the first cohort of 56 Dutch soldiers show few cases of PTSD (n=2), and no cases of mTBI on clinical assessment. Fatigue and subjective concentration problems were found in respectively, 12 and 21%. Impact of the event was reported as mild in most cases. Conclusions: These first results show mild effects on subjective symptom reporting after blast exposure, except for fatigue and subjective concentration. Extensive neuropsychological assessment indicated a reduced ability to store new information and an impairment of the long-term memory in a significant group. A limitation for the interpretation of these data is the absence of a control group, yet, the performance is remarkable and will need to be followed up. Careful recording of effects of blast exposure through targeted screening and structured assessment is essential to evaluate symptom onset, and long-term effects.