Introduction This is the first study using national data to evaluate transportation risks among Emergency Medical Technician (EMTs) and Paramedics (to be referred to hereafter as 'EMTs') in the United States.HypothesisThis epidemiological study compares the transportation risks for EMTs to the transportation risks for all workers in the U.S.MethodsWe describe rates, relative risks and proportions associated with the 1,050 injury cases with lost work days and 30 fatalities resulting from transportation incidents occurring to EMTs in the U.S. between 2006 and 2008. ResultsThe risk of transportation related injury for EMTs is about five times higher than the U.S. national average. Females were the victims in 53% of the cases yet females only accounted for about 27% of employment in this occupation. Twenty percent of cases resulted in 31 or more lost work days. There were 30 transportation related fatalities.ConclusionsThe U.S. national EMS system is built on the premise of having an unlimited supply of 20 year olds interested in, and dedicated to, the provision of EMS care. Not only do we not have an unlimited supply of 20 year olds, we may be rapidly losing our current workforce through clearly preventable risks such as transportation incidents. EMS workers face a rate of occupational injury that is much higher than the national average and transportation related events are a significant component of that risk. Resources must be devoted to further research and to the development and evaluation of interventions designed to mitigate these transportation-related hazards.