Industrial firefighters share many characteristics with municipal firefighters; however, employers frequently have not addressed or characterized the unique job duties, hazards, and specific physical/mental demands associated with industrial firefighting. In addition, gaps exist in the medical literature with regard to industrial firefighter demographics, behavioral risk factors, and chronic diseases. Finally, the proper methodologies for fitness-for-duty assessment of employees acting in this capacity are lacking. To address these gaps, the American College of Occupational and Environmental Medicine (ACOEM) convened a Task Force in 2014, to develop fitness-for-duty guidance for industrial firefighters. This document highlights these gaps and suggests research opportunities to enhance the health and safety of this population. While an extensive literature review found a lack of studies for this population—thus excluding the development of an evidence-based document—sufficient materials were available from which to draw preliminary conclusions, considerations for best practices, and recommendations for future studies.