A national investment in EMS research infrastructure is necessary to overcome the obstacles currently impeding EMS research. Funding is needed to train new researchers and to establish their careers. Increased financial support is necessary to develop effective prehospital treatment for the diseases that drive the design of the EMS system, including injury and sudden cardiac arrest. Innovative strategies to make EMS research easier to accomplish in emergency situations must be legitimized and implemented. Researchers must have access to patient outcome information so that the impact of prehospital patient care can be evaluated and improved. Incorporating standard scientific methodology into the evaluation of biomedical and technical advances in prehospital care is crucial. Research is the key to maintaining an appropriate focus on improving the overall health of the community in a competitive and cost conscious health care market. Most importantly, research is essential to ensure that the best possible patient care is provided in the prehospital setting.