Why do so few wounded Russian soldiers survive?

The ratio of dead to wounded in war has long served as a diagnostic of a military’s medical competence, tactical proficiency, and the general nature of combat. In most modern conflicts since the Second World War, roughly three soldiers are wounded for every one killed. On the Russian front line in Ukraine, however, the inverse appears to be true. Western intelligence estimates suggest that among Russian troops, the proportion of those killed is unusually high — sometimes approaching parity with, or even exceeding, the number of wounded. This anomaly reveals much about how Russia is fighting the war, the conditions under which her soldiers operate, and the limitations of her command and medical systems.

The Historical Norm and Its Breakdown

In the Second World War, advances in field medicine and rapid evacuation by vehicle or aircraft meant that most soldiers struck by shrapnel or bullets survived if they could reach medical care. The Vietnam War improved this ratio still further: helicopter evacuation and triage meant that the dead-to-wounded ratio in US forces fell below 1:6. In Iraq and Afghanistan, widespread use of body armour, tourniquets and trauma care pushed survivability to historic highs. Under normal circumstances, one expects three to five wounded for every death.

On the Russian front in the war in Ukraine, the reported figures are dramatically different. Ukrainian and Western sources estimate that by 2025 Russia may have lost more than a million men, with some analysts suggesting that roughly half of these are dead rather than merely wounded. This suggests a wounded-to-dead ratio near 1:1 — a pattern normally associated with the First World War or with armies fighting without any organised medical system.

Causes: Neglect and Attrition Warfare

Several factors combine to explain this reversal. First is the Russian army’s deliberate reliance upon attrition tactics. Human-wave assaults, conducted by penal battalions or recently mobilised conscripts, are designed not for survivability but for exhausting Ukrainian ammunition and defences. Soldiers are often thrown forward without body armour, tourniquets or medical training, and they assault across mined ground under Ukrainian drone observation. The purpose is not to hold the line but to die while advancing it.

Second, the Russian evacuation chain has broken down almost completely. Modern war demands that wounded soldiers be retrieved within the “golden hour” to have any real chance of survival. Russian units however lack armoured ambulances, helicopter evacuation, and sometimes even stretchers. Many casualties are left for days on the battlefield. Drones have made any movement behind the lines hazardous, so both sides avoid sending vehicles forward for fear of being targeted. In such an environment, a wounded man often dies of exposure or blood loss before reaching any aid post.

Third, Russian battlefield medicine remains primitive. Field hospitals near the front are overwhelmed, short of antibiotics, anaesthetics and trained surgeons. The destruction of civilian hospitals in occupied territories has diverted what few resources exist to treating local populations, leaving wounded soldiers to be stabilised in tents or barns. The result is a mortality rate that would have been unacceptable even in 1916.

Strategic Implications for Russia

The high death rate has two profound implications for Russia’s conduct of the war. The first is demographic. Russia’s population is ageing and declining, and the loss of hundreds of thousands of men of military age cannot easily be replaced. Even the Kremlin’s extensive mobilisation of prisoners, migrants and Central Asian recruits cannot mask the haemorrhaging of manpower. A war that kills rather than merely wounds erodes the national labour base more quickly, undermining both military and economic sustainability.

The second is moral and political. An army that abandons its wounded ceases to function as a moral institution. Russian soldiers now understand that if injured, they are unlikely to survive; consequently, unit cohesion collapses and discipline relies ever more upon coercion and fear. Reports of Russian commanders shooting deserters, or of blocking detachments firing upon retreating troops, testify to an army fighting against its own psychology as much as against Ukraine. In this sense, the low wounded-to-dead ratio is both symptom and cause of systemic brutality.

Implications for Ukraine and the Wider War

For Ukraine, this pattern offers both advantage and caution. Russian tactics that sacrifice lives without tactical gain may deplete Moscow’s manpower faster than Kyiv’s Western allies can be exhausted. Yet such tactics also indicate that the Kremlin is prepared to expend lives indefinitely to hold ground. The high death rate means Russia’s army is becoming a rotating mass of untrained recruits, losing institutional memory and professionalism. But it also means that Russia has accepted the logic of total war: she will fight until her pool of expendable men is gone.

Conclusion

The unusually low proportion of wounded to dead amongst Russian forces in Ukraine is not a statistical curiosity but a window into the war’s brutal logic. It reflects an army that treats its soldiers as disposable, lacks the logistical and medical capacity to save them, and is willing to trade blood for time. Whereas modern armies fight to preserve life, Russia’s current strategy fights by consuming it. This calculus of mortality may yet determine not only the course of the war but the moral decay of the Russian state itself.