Emergency Medical Services (EMS) in South Korea were formally established in 1982 meaning that they are relatively young in comparison to western counterparts. The handling of the 1988 Seoul Olympics earned widespread global support. Recent disasters have, however, brought the nation's preparedness into question. EMS provides life-critical pre-hospital emergency care. In South Korea, services are free at point-of-use, and, like several other countries, they are experiencing ever higher levels of stress. Budget cuts, personnel shortages, and increasing operational tempo are known stressors that cause individual and organizational harm which compromises disaster preparedness. Interestingly, EMS in South Korea suffer from poor social acknowledgement within a rank-based society that venerates firefighting and specialist rescue units. EMS are deemed less prestigious; this constrains their organizational voice, minimizes leadership representation, and reduces morale. Recent visceral disaster experience and the limited research focused expressly on the socio-cultural context of EMS provision in South Korea constitute a pertinent research gap. Accordingly, this study critically evaluated perceptions of the experiences and challenges faced by EMS crews in Incheon, South Korea.Constructivist grounded theory, semi-structured interviewing, and induction underpin 24 interviews that address the experiences and challenges faced by EMS. The resultant 24 codes, eight categories, and three themes drawn from 253 quotations are presented within a comprehensive network diagram that provides the building blocks of a new tentative theory. The posited EMS organizational efficiency model is, therefore, grounded within empirical data and is designed to mitigate chronic stressors and enhance disaster preparedness.