It was established on March 17, 1996, following the merger of the FDNY and New York City Health and Hospitals Corporation's emergency medical services division.

FDNY EMS provides coverage of all five boroughs of New York City with ambulances and a variety of specialized response vehicles.

Field Operations is divided into three citywide geographical area, (Central, North & South) each led by an EMS Deputy Assistant Chief, then into nine divisions.

FDNY EMS is also responsible for managing emergency medical care for all mass casualty incidents (MCI's) in New York City.

Initial and refresher training for the Haz-Tac battalion is conducted on Randalls and Wards Islands on the FDNY Fire-Suppression Academy campus.

The FDNY Bureau of EMS utilizes custom specification Type I Ambulances, which are based on the chassis-cabs of light and medium duty pickup-trucks.

In 2011, the FDNY began ordering ambulances from Wheeled Coach which are based on a Dodge Ram 4500 Crew Cab Chassis.

In 2016, FDNY EMS ordered and received new International Terra-Star/Wheeled Coach Medium Duty Ambulances for use as "Rescue Medic" vehicles.

In 2020, FDNY EMS began to lease ambulances to augment the fleet as call volume increased dramatically.