WHO conducted a qualitative and quantitative survey of emergency medical services (EMS) across Ukraine in 2019 to build a comprehensive picture of the challenges and opportunities facing EMS. The study used a range of methods for collecting and analysing data. In general terms, it was a cross-sectional study with retrospective elements. Qualitative and quantitative components were included to cover all levels of the EMS system, from regional health administrative staff to ambulance drivers, with end-user patients included. EMS systems and prehospital care are critical in saving lives and decreasing morbidities, but they are challenging to evaluate. A newly adopted law has assigned administrative and financial responsibilities for prehospital emergency care to EMS centres at regional level, moving from fragmented district-based supervision to a more coordinated, regional approach. This survey aims to provide evidence-based recommendations for the Ministry of Health to improve the overall quality of EMS in Ukraine.  The survey outlines core approaches needed in EMS reform in Ukraine, with key suggested interventions, and proposes strategic directions.