A collision between a barge and an oil tanker of Hebei Spirit caused the release of an estimated 12,547 tons of light crude oil into the Yellow Sea off the west coast of Taean-gun, Korea on December 7, 2007. This study was aimed to evaluate exposure conditions and acute health effects in soldiers participating in the Hebei Spirit oil spill cleanup activities and the association between these and the nature of the work and use of protection devices. The sample comprised 2,624 soldiers stratified by working area and number of working days. We divided working area into the coast of Taean-gun(highly polluted area) and other areas affected by Hebei Spirit oil spill. And we divided number of working days into 1-7 days, 8-14 days, 15-21 days and above 22 days. Data were obtained via a structured, self-administered questionnaire and included information on working area, type of working, number of working days, use of protective materials, and acute health effects. Acute health effects were classified into 5 groups: neurological, respiratory, dermatologic, ophthalmic and other symptoms. Data analysis was performed using unconditional logistic regression used to compute odds ratios and 95% confidence intervals. On logistic regression analysis, working on the coast of Taean-gun was significantly associated with increased risk of acute health problems: headache, dizziness, nausea, general fatigue, insomnia, flushed face, sore throat, dry throat, runny nose, cough, sputum, skin irritation, sore eyes, injection of conjunctiva, tear, and low back pain. Furthermore soldiers working more than 21 days were significantly associated with increased risk of acute health problems: insomnia, flushed face, sore throat, runny nose, cough, sputum, tear, low back pain and fever. Accordingly, the exposure to the oil and the subsequent cleanup efforts were suggested to inflict acute health problems on soldiers participating in the Hebei Spirit oil spill cleanup activities.