A-Ressha de Ikou MD is an entry in Artdink's A-Ressha de Ikou series of railroad simulation games, otherwise known as Take the A Train or simply A-Train.

A Ressha de Ikou MD was released exclusively on the Sega Mega Drive in 1992, being ported by MNM Software (according to founder Mikito Ichikawa). The game refers to games created by Artdink in 1989 and 1991, which may suggest elements were taken from A Ressha de Ikou II or A Ressha de Ikou III released around that period.

Like most entries in the series, A Ressha de Ikou MD was not released outside of Japan, although A Ressha de Ikou III, rebranded as A-Train was brought to western computers by Maxis, also in 1992.