[1] CALSTAR was founded as a nonprofit public-benefit corporation in 1983 and began flight operations the following year using a leased BK 117 helicopter based at Peninsula Hospital in San Mateo, California.

Since its inception, CALSTAR has provided air medical transport services to over 50,000 critically ill and injured patients and logged over 75,000 accident-free flight hours.

All medical care provided by CALSTAR is held under scrutiny from the organization's quality assurance/quality improvement program, which is protected under Section 1157.5 of the California Evidence Code.

In 2009, CALSTAR completed a six-year project to retrofit its fleet of Eurocopter BO-105 LS aircraft with upgraded Rolls-Royce 250-C30P model engines, an enhancement designed to improve safety while significantly reducing emissions and operating costs.

The FAA granted CALSTAR a Supplemental Type Certificate (STC) approving the engine retrofit for the entire BO-105 LS fleet nationwide.

CALSTAR also received FAA approval in 2009 for the first three helicopters Wide Area Augmentation System (WAAS) GPS approach procedures in the world.