A 41-year-old member from Germany experienced respiratory distress while trekking near Kulin, Tajikistan, at approximately 13,500 feet/4,100 meters. Symptoms began with a cough and headache, then progressed to chest pain, fever and coughing up pink-tinged sputum. With no guide accompanying the trek, his wife and a nearby French mountain guide provided initial assessment and care. Despite rest and hydration, his condition worsened, making self-evacuation impossible. Global Rescue arranged a complex ground evacuation involving a horse-assisted descent over several days and vehicle transport to a hospital in Khorog. There, he was diagnosed with rhinopharyngitis and discharged with supportive care instructions. Global Rescue medical staff reviewed the case and found the treatment appropriate. The member resumed his travel plans and expressed appreciation for the support provided. This case demonstrates the value of coordinated ground rescue in high-altitude remote rescues.