[3]: 11  The first officer was 36-year-old Madeline "Mimi" Tompkins,[5] who also had significant experience flying the 737, having logged 3,500 of her total 8,000 flight hours in that particular Boeing model.

[3]: 11 Flight 243 departed from Hilo International Airport at 13:25 HST on April 28, 1988, with 5 crew members and 90 passengers on board, bound for Honolulu.

[3]: 2  Nothing unusual was noted during the pre-departure inspection of the aircraft, which had already completed three round-trip flights from Honolulu to Hilo, Maui, and Kauai earlier that day, all uneventful.

[3]: 2 After a routine takeoff and ascent, the aircraft had reached its normal flight altitude of 24,000 feet (7,300 m), when at around 13:48, about 23 nautical miles (43 km; 26 mi) south-southeast of Kahului on the island of Maui, a section on the left side of the roof ruptured with a "whooshing" sound.

[3]: 2  The captain felt the aircraft roll to the left and right, and the controls went loose; the first officer noticed pieces of grey insulation floating in the cockpit.

"[3]: 2  A large section of the roof had torn off, consisting of the entire top half of the aircraft skin extending from just behind the cockpit to the fore-wing area,[6] a length of about 18 feet (5.5 m).

Air traffic control radioed Akamai and requested as many of their 15-passenger vans as they could spare to go to the airport (which was 3 miles (4.8 km) from their base) to transport the injured.

[9] Investigation by the U. S. National Transportation Safety Board (NTSB) concluded that the accident was caused by metal fatigue exacerbated by crevice corrosion.

All 737s constructed after line number 291 included an additional outer layer of skin or doubler sheet at the lap joint of the fuselage.

[3]: 13–21 The additional outer layer construction improved the joint by: The NTSB investigation determined that the quality of inspection and maintenance programs was deficient.

[3]: 71 The NTSB concluded in its final report on the accident:[3]: 73–74 The National Transportation Safety Board determines that the probable cause of this accident was the failure of the Aloha Airlines maintenance program to detect the presence of significant disbonding and fatigue damage which ultimately led to failure of the lap joint at S-10L and the separation of the fuselage upper lobe.

Contributing to the accident were the failure of Aloha Airlines management to supervise properly its maintenance force; the failure of the FAA to require Airworthiness Directive 87-21-08 inspection of all the lap joints proposed by Boeing Alert Service Bulletin SB 737-53A1039; and the lack of a complete terminating action (neither generated by Boeing nor required by the FAA) after the discovery of early production difficulties in the B-737 cold-bond lap joint, which resulted in low bond durability, corrosion, and premature fatigue cracking.One board member dissented, arguing that the fatigue cracking was clearly the probable cause, but that Aloha Airlines maintenance should not be singled out because failures by the FAA, Boeing, and Aloha Airlines maintenance each were contributing factors to the disaster.