Objective To explore the application of a state transition queue model in the research of injury evolution of the wounded during wartime, so as to predict the number and state of the wounded at different phases and to evaluate the therapeutic effects of different treatment plans. Methods Taking common naval combat injuries as an example, we used the expert interview method to obtain the outcome probability data of the wounded at different time points and with different treatment plans. A state transition queue model comprising 3 states (death, pending evacuation, and returning to duty) was established to predict the evolution and outcomes of the wounded with different treatment plans. Results Assuming an initial state of 100 wounded pending evacuation, a comparative analysis of 7 treatment plans by the medical teams of the ship formation was conducted. The results showed that Plan 4 (primary first-aid within 10 min after the injury, advanced first-aid within 1 h, and early treatment within 3 h) resulted in the fewest deaths (21.4 individuals) and the highest number of returning to duty (53.8 individuals), indicating the most significant treatment effect. Conclusion The state transition queue model has potential value in studies of the injury evolution of the wounded during wartime, offering effective decision support for developing support plans and regulating support actions, but it still needs further refinement.