Purpose : The emergency medical service (EMS) system in Japan is simila r to that in Korea. This study reviewed the development of paramedics who are major personnel in the respective EMS system of their country.Methods : We searched law for paramedics and publications in J-stage, MEDLINE and the webpage of Japan's Fire and Disaster Management Agency. Results : Paramedic training had started in Japan in 1991, and most par amedics were employed in fire departments. In Japan, ambulances belonging to fire department are staffed by a three-person unit, including at least one paramedic. Medical control advisory boar ds were established in all Japanese prefectures in 2003 with the purpose of upgrading the activitie s of ambulance personnel, including paramedics. The scope of paramedics' work has been widened owing to the continued efforts of medical control advisory boards. This allows them to perform invasive procedures including tracheal intubation, intravenous line placement, and epinephrine administration unde r medical control of a physician.Conclusion : As paramedics' responsibilities expand, further development o f the paramedic role and an effective medical control advisory board system are imperative both Korea and Japan.Key words : Paramedics, Japan, Training, Role, Medical control advisory board 투고일: 2014년 7월 4일 심사완료일: 2014년 8월 1일 게재확정일: 2014년 8월 18일