Ambulance crashes, and the resulting injuries, fatalities, and liability, have elevated the discussion of ambulance safety to an urgent level. This chapter includes an introduction to the issue and an exploration of the factors related to crashes, and concludes with recommendations for ways in which EMS professionals, medical directors, and agency administrators can help mitigate this serious problem. There is an average of ten transportation‐related fatalities per year among EMS personnel in the US. The rate of transportation‐related occupational injuries for EMS personnel is more than 30 times higher than the national average. They are not “accidents”; rather, they are predictable, preventable events. Working together, we can pursue a vision of improved ambulance safety and zero fatalities from ambulance crashes. This means EMS professionals working with physicians, engineers, epidemiologists, researchers, manufacturers, government officials, and others to conduct rigorous research, analyze the problems, develop, test, and implement solutions, and share best practices.