Wilderness First Aid is a common certification for outdoor recreationists, educators, and trip leaders. A panel of educators, researchers, and clinicians evaluated 15 core and eight elective WFA practices for strength of recommendations based on the quality of supporting evidence and balance between the benefits and risks/burdens according to the methodology stipulated by the American College of Chest Physicians. The strength of the evidence for these 23 WFA practices varies widely because of scant published research to date. When no evidence existed, the panel based recommendations on a consensus of the panelists for risk/benefit and best practices. This review clearly points out the need for conducting greater research to strengthen the level of evidence in numerous WFA topics and for educational strategies that improve retention of core knowledge, as well as skill application for the lay first aid provider.