Objective: In military aviation, high performance aircraft pilots are exposed to +Gz acceleration at longer durations and higher magnitude than transport/helicopter pilots. The purpose of this study was to reveal the negative or positive cardiac responses to this occupational high +Gz exposure. Methods: Our study design was cross-sectional and observational. We have evaluated 21 echocardiographic parameters of 63 pilots who applied for aircrew periodic medical examination. Of 63 pilots, 33 were grouped as high performance aircraft pilots group (Group A) and 30 were grouped as control group (Group B) whose aircraft type was transport or helicopter. Means of demographic and echocardiography parameters between two groups were compared statistically with Student's t-test, Mann- Whitney U or Chi-square test as appropriate. Results: Among all echocardiographic parameters, mean TV A (tricuspid valve peak velocity during late diastolic filling) was significantly higher and TV E (peak velocity during early diastolic filling)/ A ratio was significantly lower for Group A pilots (p<0.05). In Group A pilots, mean TV A and TV E/A ratio were (52.12±13.85) and (1.36±0.30) respectively. In Group B pilots, mean TV A and TV E/A ratio were (42.61±6.42) and (1.53±0.20) respectively (p=0.001 for TVA and p=0.005 for TV E/A). Mean pulmonary artery pressure (PAP) of Group A pilots (32.04±9.09) was higher than Group B pilots (28.76±7.9) but it was not statistically significant (p>0.05). Conclusion: We conclude that according to the results of our study, long term +Gz exposure has no effects on cardiac morphologic and systolic functions but has effects on right ventricular diastolic functions. We have considered that these effects may be a result of chronic +Gz adaptation or high PAP levels.