In many developing countries, transportation infrastructure development lags behind the tremendous growth in motorization. Road traffic injuries cause enormous morbidity and mortality worldwide, placing heavy burdens on global and national economies. Underdeveloped transportation infrastructures critical to traffic safety include roadway improvement, occupant protection laws, traffic law enforcement, and emergency medical services (EMS). Highlighting one important aspect of lagging infrastructure, this article focuses on emergency medical services. This research study offers a descriptive evaluation of the existing pre-hospital care system in Chiang Mai, Thailand. The research objectives were (a) to describe how emergency rescue services are organized in Chiang Mai, (b) to examine ongoing public health efforts to improve emergency services, and (c) to document the training, certification, employment, and medical use of prehospital personnel. Thailand’s national and local pre-hospital services (i.e., services designed to transfer persons with traffic injuries into the country’s hospital infrastructure) are both insufficient and inefficient. The Thai National Government has promised funding to create a national EMS network by 2006. Research recommendations for Thailand EMS include more professional training for emergency workers, standardization of equipment, centralization of communications, and further analysis of competitive services.