Background: One of the most pervasive barriers to Palestinian health is a complex system of medical permits needed to leave the inadequately resourced Palestinian territories to receive care in Israel or a neighboring Arab state. In 2017, it is estimated that 57 Palestinians died due to denial or delay of permits. Proponents insist that these permits and other movement restrictions are necessary due to security concerns. This study will test that argument. Methods: I obtained medical permit data from the Gaza Strip and West Bank for the years 2011-2020 from monthly reports issued by the World Health Organization. To assess whether levels of conflict or security threats influenced the permit approval process, I evaluated the Israeli Global Peace Index and Global Terrorism Index scores (2020) and Israeli fatality and injury data from OCHA (2020). Trends were assessed using descriptive statistics and regression analysis. Findings: From 2011-2019, medical permit applications, especially from the Gaza Strip to enter Israel, have increased as the Palestinian population has increased. However, the percentage of approved permits has decreased annually as the level of denied and delayed permits has increased. Using linear regression, none of the predictor variables- presence of active conflict, GPI, GTI, and number of Israeli injuries/fatalities- showed any statistically significant association with the level of permits approved, delayed, or denied in Gaza. Importantly, almost no reports of medical permit abuse resulting in terrorism could be found. Conclusions: Analysis of the trends in the medical permit system, based on the limited and inconsistent data available, suggests that although Israel has become more secure over the past nine years when the data was compiled, the permit regime has grown more restrictive. Recommendations to improve Palestinian ability to access health care outside of a comprehensive and just political resolution are discussed.