Background: Sleep deprivation, weighted road march combined with short term high intensity physical activities are important aspects of army ranger operations, which can lead to inflammation, muscular injury, and physical and shooting performance loss. On the other hand, animal and human studies documented that choline supplement relieves inflammation and improves physical and mental performances. The aim of this study was to examine the effect of choline supplementation on serum creatine kinase and IgA, macular endurance, and shooting accuracy of army rangers following one-day simulated operation. Methods: Twenty army rangers voluntarily participated in this double-blind, placebo controlled quasi-experimental study. The