Enhanced radiation weapons (ERW) are fission-fusion devices where the massive numbers of neutrons generated during the fusion process are intentionally allowed to escape rather than be confined to increase yield (and fallout products). As a result, the energy partition of the weapon output shifts from blast and thermal energies toward prompt radiation. The neutron/gamma output ratio is also increased. Neutrons emitted from ERW are of higher energy than the Eave of neutrons from fission weapons. These factors affect the patterns of injury distribution; delay wound healing in combined injuries; reduce the therapeutic efficacy of medical countermeasures; and increase the dose to radiation-only casualties, thus potentiating the likelihood of encountering radiation-induced incapacitation. The risk of radiation-induced carcinogenesis is also increased. Radiation exposure to first responders from activation products is increased over that expected from a fission weapon of similar yield. However, the zone of dangerous fallout is significantly reduced in area. At least four nations have developed the potential to produce such weapons. Although the probability of detonation of an ERW in the near future is very small, it is nonzero, and clinicians and medical planners should be aware of the medical effects of ERW.