It is definitely necessary to train pilots for hypoxia symptoms, as accident reports, both military and civilian has proved. Traditional training was done in the altitude chamber, a device that simulated with a great degree of fidelity the physiological problems encountered in flight. However, perils of the altitude chamber, decompression sickness being the most cited upon, make this a less than perfect training modality, although the altitude chamber realism stays paramount. Recently there are reports have showed that hypoxia training in chamber is not full proof. Computer assisted learning in chamber it is still not deployed as far as our knowledge goes. A device for on ground hypoxia might be an answer, if not as replacement, at least as a complementary for this training problem. Method: We we have employed a ground hypoxia simulator, a commercially available medical grade device. The principle of on ground hypoxia demonstration is detailed, as well as the tests given for self evaluation. A comparison of recognized symptoms versus altitude chamber training was performed, based on the symptom check list form the ground simulator (basically the forms were the same, only one filled on the computer, the other one by hand). Results: The new method of training lead to improved symptom recognition, generally more symptoms being reported in the on-ground device. Most recognized symptoms were in the mental calculus and in the motor skills category. Statistically, there were no significant differences for symptoms distribution, p value ranging from 0.06 to 0.6, except for the mental symptom reporting (p=0.018, Z=2,36). Brief physiological insights on this difference ground are presented. The study design did not allow us to test computer training efficiency comparison (no way to deploy that in the altitude chamber). Conclusion: The on ground hypoxia training is a valid and useful complementary training method to the classic paradigm of altitude chamber training.