Some residents have moved back home and other businesses have re-opened but the devastating signs of the Missouri River flood can still be seen especially from the air.
Mercy Air Care officials gave KTIV News 4 a bird's eye view to see what areas around Siouxland look like almost one year later.
While the water has receded, sand has been left in its place.
MAC personal say it's a sight to see.
"It's amazing to see how much water there really was out there. When we saw it last year, you see the water and you realize the flooding but now when you can see where it's dry where there was water there, it's quite amazing," Susie Pick, MAC Flight Nurse, said.