Physical fitness and health are closely linked. However, regular workplace assessments of paramedic health and fitness are not conducted, despite increasing evidence that the role requires a high level of fitness due to increasing physical and psychological demands. Describing the physical attributes required to complete the day-to-day tasks of a paramedic is problematic as data has not been collated. Recent registration, and significant illness and injury rates of paramedics in Australia, make systematic identification of the role more important in order to set a standard criteria. Objective This systematic literature review set out to define: 1) paramedic health status and the physical tasks performed; and 2) level of requisite fitness required to complete paramedic tasks. Results Using systematic search strategies, 24 articles were appraised and generally conclude that paramedics have a poorer health status and fitness levels compared to the general population, despite often performing physical heavy handling tasks. Conclusion General themes were highlighted throughout the literature, identifying that further research needs to be conducted to identify the day-to-day tasks of a paramedic and what level of requisite fitness is required. Current health and fitness is lacking for physical heavy handling activities performed in the paramedic role.