Sri Lanka is a developing country in South Asia with a per-capita GDP of 7900 USD. According to the world health report 2006, more than 90% of injury-related deaths occur in low and middle income countries. Traumatic injuries continue to be the leading cause of hospitalization since 1995 in Sri Lanka. In 2008, more than 650,000 admissions to government hospitals were due to traumatic injuries with 1022 deaths. But still the Emergency Medical Service (EMS) in Sri Lanka is in an embryonic stage with a history of 10 years. The aim of this study is to evaluate the current practice of Emergency Medical Service in Sri Lanka. We collected information of EMS system in Sri Lanka from the websites of Medical Teams International, Trauma Secretariat of Sri Lanka Ministry of Healthcare and Nutrition, and WHO "Pre Hospital Trauma Care Systems", and put them together. There are eight health centers providing EMS, only to a very limited area around them in Sri Lanka. Almost all pre-hospital health care providers in Sri Lanka are at the level of first responders, without any continuation of training and education. There is a board of Emergency Medicine Physicians in Korea, but in Sri Lanka it``s at the starting point. But in Korea, there is a well established emergency number 1-1-9 with good public awareness. None of the systems in Sri Lanka has a sufficient number of ambulances to respond to all emergency calls they receive, while South Korea uses even helicopters. Need more funds and developments in many aspects such as producing emergency medicine specialists and emergency medical technicians, continuing of training, island-wide combined emergency medical service with a national communication center and educating the public, in compared to EMS in South Korea.