In Lithuania pre-hospital medical services were started at the end of the 19th century. Emergency care for patients is provided free of charge and funded from a Compulsory Health Insurance Fund and by Government. Ambulance response target times are 15 min in urban areas and up to 30 min in rural areas. Personnel on ambulances consist of nurses and physicians. In the near future it is expected that paramedics will replace ambulance drivers. The emergency medical system is in a transition period: Admission departments are developing into emergency departments, residency programmes for emergency medicine are being prepared, and emergency medicine is going to be recognised as a separate specialty.