Background: The EMS in Saudi Arabia has seen a number of positive changes, including the establishment of several university and college programmes dedicated to teaching EMS. Methodology: The EMS Department has a tiered pre-hospital emergency medical services (EMS) response. The first week of training includes airway management training. Early exposure to BLS and ALS airway techniques allows for the greatest amount of procedural experience Results: Emergency airway management is a critical component of critically ill patient resuscitation. The factors that contribute to this variation in success can be classified into three categories: system factors, patient factors, and paramedic experience. Conclusions: The implementation of a widespread EMS system in Saudi Arabia will not only improve patient safety and clinical outcomes, but will also have a positive impact on the health of our communities, resource utilisation, and the economy