Objective: To determine cognitive impact of insecurity on first line paramedics in Chaman, Qilla Abdullah Baluchistan health care facilities. Methods: This is a KAP study conducted among public and private sector first line paramedics, senior security officers, medical consultants and employees of law enforcement agencies. Cognitive impact of insecurity was calculated with the help of Questionnaire consists of 10 statements with a Cronbach Alpha reliability. Basic data was gathered on 5 point Likert scale however, for final assessment, options of ‘Strongly Agree and Agree’ were merged together while options of ‘Disagree and Strongly Disagree’ were merged for a clear picture of the opinion of the respondents. Results: In this study 56 personnel participated, out of which 48 (85.7%) were males. Physical and human insecurity were classified as major types of insecurity (76.2%). Major sources identified were cross border terrorist/militant attacks, violent extremism incidents, sub-standard medical facilities/infrastructure, degraded socio-economic facilities and lack of awareness. Severe psychological and behavioural disorders was observed at various stages and groups both in Public and private sectors first line paramedics. Conclusion: Pakistan is facing diverse security challenges. It has impacted all the segments of our society. First line paramedics are considered as essential services and actively involved in supporting warwounded/terrorism hit patients at western borders. Due to poor security conditions and lack of facilities these medical operators are facing various security issues affecting their psychological behavior.