BACKGROUND: Emergency medical services (EMS) play an essential role in treating and transporting patients to hospitals or between hos-pitals. EMS providers must be distributed wisely across all regions of the country to meet healthcare needs during normal times and disas-ters. No previous study has investigated the characteristics and distri-bution of the EMS workforce in Saudi Arabia.OBJECTIVES: Examine the characteristics and distribution of the EMS workforce in Saudi Arabia to identify gaps and areas in need of im-provement. Also, explore the sociodemographic and educational char-acteristics of licensed EMS providers in Saudi Arabia.DESIGN: Cross-sectionalSETTINGS: EMS in Saudi ArabiaMETHODS. We included all licensed EMS providers in Saudi Arabia as of 23 December 2020 who were registered in the Saudi Commission for Health Specialties (SCFHS) database. Sociodemographics, where they earned certification, and their job affiliations were collected and categorized.MAIN OUTCOME MEASURES: EMS workforce distribution, gender, and EMS provider-to-population ratio. SAMPLE SIZE: 18 336 EMS providers; 8812 (48.1%) with documented job affiliations.RESULTS: The EMS provider-to-population ratio is very low. In Saudi Arabia, in general, the ratio is 1:3871 (based on n=8812 providers), which is low compared to the 1:1400 ratio for Australian EMS provider -to-population, for example. That makes it a challenge for EMS provid-ers to meet the population's needs, especially in times of disaster. The low ratio may have contributed to the delayed response time in Saudi Arabia (13 minutes for critical cases) which does not meet the interna-tional standard response time (8 minutes maximum). Also, only 3.5% of the total EMS providers registered were females, and the clear majority of all EMS providers were technicians.CONCLUSIONS: The growth in the EMS workforce, including the re-cruitment of more females into the workforce and more EMS specialists compared to EMS technicians and health assistants, is critical to reach-ing a satisfactory EMS provider-to-population ratio.