The pre-and interhospital transportation of emergency patients has growing during the recent years to be al full-fledged component of medical practice. With this grow has arisen a need for discussion of the emergency patients transportation system required to carry out the transportation in Korea. All patients to transferred by transportation system have a common feature: the need during transportation for high-level intensive care and monitoring by specialized medical teams and equipments. This article reviewed the emergency medical service system of France (SAMU), West Germany and Japan, we proposed the following preliminary guidelines for emergency patients transportation system in Korea. 1) Emergency medical service system 2) Emergency medical hospitals 3) Emergency service area 4) Emergency transportation vehicles (ambulance, helicopter) 5) Communication system 6) 119 ambulance service system 7) Education and training of the emergency medical persons 8) Care for mass accidents.