The Persian Gulf War was a conflict between Iraq and a coalition force of 34 nations led by the United States. The lead up to the war began with the Iraqi invasion of Kuwait in August 1990 which was met with immediate economic sanctions by the United Nations against Iraq. The coalition commenced hostilities in January 1991, resulting in a decisive victory for the U.S. led coalition forces, which drove Iraqi forces out of Kuwait with minimal coalition deaths. Despite the low death toll, over 180,000 US veterans would later be classified as "permanently disabled" according to the US Department of Veterans Affairs (see Gulf War Syndrome). The main battles were aerial and ground combat within Iraq, Kuwait and bordering areas of Saudi Arabia. Land combat did not expand outside of the immediate Iraq/Kuwait/Saudi border region, although the coalition bombed cities and strategic targets across Iraq, and Iraq fired missiles on Israeli and Saudi cities.