Low- and middle-income countries (LMICs) are now facing a triple burden of injuries, communicable, and non-communicable diseases. LMICs generally, and poor people in individual countries are particularly at the risk of higher burden of injury and adverse outcomes from a variety of acute and life-threatening conditions. The odds of dying due to injuries is six-times higher in the absence of a well-organized and coordinated Emergency Medical System (EMS). Research has demonstrated that EMS could significantly reduce morbidity and mortality from road traffic injuries, acute cardiovascular diseases, sepsis and obstetrical complications. Despite the high burden and increased risk of death from injuries, the availability and quality of EMS in LMICs are extremely variable. This session will highlight the state of EMS in three different LMICs, describing the needs, challenges and priorities in the format of case studies. This two-hour symposium aims to put forward a compelling narrative of the cross cutting role of EMS in strengthening emergency and trauma care to inform and promote current and future strengthening of EMS in LMICs. 10 min Welcome and Overview of Emergency Medical Services in LMICs: Dr. Adnan Hyder 25 min ‘It’s hard to get an ambulance’- Findings of an assessment of the Emergency Medical System in Kampala, Uganda using Health systems framework: Dr. Amber Mehmood, JH-IIRU 25 min Towards a better emergency care: Evolution of Emergency Medical Services Policy in Kenya: Dr. Isaac Botchey, JH-IIRU 25 min Overview of Emergency Medical Services in Pakistan: A comparison of public and private run services: Dr. Razzak Junaid, Department of Emergency Medicine, Johns Hopkins 20 min Steps forward: Are there any ‘best models’ for Emergency Medical Services in low-resource settings? Dr. Olive Kobusingye Makerere University School of Public Health 15 min Discussion/Question and answer session. Dr. Adnan Hyder.