This paper focuses on medical neutrality as impartiality as a ground for rationing medical care in the context of armed conflict. Impartiality is often taken to entail that medical professionals should not discriminate between patients on “morally irrelevant grounds”. Common examples of such grounds are age, gender, nationality, and political affiliation. This, in turn, is an idea akin to a principle of formal justice. Accordingly, medical neutrality as impartiality says something about how medical care should be distributed in armed conflict, or more specifically, it specifies grounds on which such care should not be distributed. However, it is unclear what this implies for rationing more specifically. The aim of this paper is to explore the concept of medical neutrality as impartiality, more specifically, to spell out the implications of medical neutrality as impartiality for the distribution of medical care in armed conflict. The paper argues that medical neutrality as impartiality must be understood as a mid-level ethical principle, rather than a high-level principle, to be applicable in practice. However, when ideas about formal justice are taken from high-level ethical theory and are applied on a mid-level, several questions arise. The paper then discusses two such questions.