The Westpac Rescue Helicopter touched down in Tamworth for the first time on a cold winter's day 20 years ago.
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The city has been a home base for the service ever since, marking the milestone on Tuesday.
The chopper of today might be a more modern machine with a bigger crew, but the service's dedication to the community - and vice versa - has seen the helicopter become a part of local life.
Tamworth's Trent Owen has been a member of the local crew for almost as long as the chopper has been based in the city.
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Mr Owen started out as a young volunteer in 2002, helping winch people to safety in their moment of need. Now, he's a full-time training and checking air crew officer - an instructor of sorts - at the Tamworth chopper base.
"I take the most pride in that we deliver safe and efficient air travel to medical teams so they can work their magic," he told the Leader.
"We take a lot out of knowing we have given our patient a better chance of making it.
I take the most pride in that we deliver safe and efficient air travel to medical teams so they can work their magic.
- Trent Owen, Training and checking air crew officer
"Nearly everyone in the community knows or knows of someone who has been directly helped by the aircraft."
The Westpac Rescue Helicopter Service (WRHS) expanded to Tamworth in the year 2000.
The crew was made up of seven volunteer rescuers and two pilots, and the helicopter was a single-engine, single-stretcher machine.
Now, there are dozens of staff members and the chopper is "state-of-the-art", Mr Owen said.
The service can't mark the milestone with the community due to COVID-19 restrictions, but Mr Owen is confident there'll be more to come down the track.
"It's basically concreted into the New England North West community now, and we'd like to see this stay here forever ... it's proven its value and its worth over and over," he said.
The helicopter's mission count has taken off over the years, and Mr Owen said its success in saving lives can't be narrowed down to one group.
"I'm continually impressed by the level of support from the community, our sponsors and partners," he said.
"The best thing is the teamwork and camaraderie displayed to make the service what it is today."
WRHS chief executive officer Richard Jones said the chopper has rallied rural communities of the New England North West together in support over the decades.
He said he's looking forward to celebrating the 21st birthday of the service in the region next year.