James B. Peake was born on June 18, 1944, in St. Louis, Missouri. In 1966, he received his BA from the United States Military Academy at West Point. He then began his military career by serving in Vietnam as a platoon leader with the 101st Airborne Division. He was wounded twice in combat and received a number of distinguished honors including a Purple Heart, Silver Star, and Bronze Star. After returning from the war, he attended medical school at Cornell University, graduating in 1972.

Peake began his medical career as an intern and later resident in general surgery at Brooke Army Medical Center in Fort Sam Houston, Texas. He served in the Army in a variety of places, including Madigan Army Medical Center in Tacoma, Washington; the 44th Medical Brigade at Fort Bragg, North Carolina; and the 18th Medical Command in Seoul, South Korea. In 2000, he was appointed the U.S. Army Surgeon General and served in that position until he retired in 2004. After leaving the military, Peake worked for Project Hope, a non-profit foundation that works to provide health care throughout the world, and QTC Management, Inc., a company that handles disability and injury examination services outsourced from the government.

President George W. Bush nominated Dr. Peake as Secretary of Veterans Affairs on October 30, 2007. He was sworn on December 20, becoming the first physician and the first general to serve as secretary for the Department of Veterans Affairs.