The highly-developed and long-established Soviet Emergency Medical System (Skoraya Meditsinskaya Pomosch) is described on the basis of personal experience of the authors.Emphasis is placed on the areas where the Soviet system seems superior to those that are only now emerging in the United States. These include: early EMS career choice; EMS generalization followed by EMS specialization; use of geographically-dispersed emergency hospitals; a highly organized communication net (Centropunct); efficient and liberal use of highly-trained EMS paramedical personnel; national standards and policy established by the central government with latitude for operational implementation at a local level.The difficult problem of professional relationship between EMS physicians and their in-patient hospital specialty colleagues is partially solved in the Soviet Union by established emergency hospitals—a system not traditional in the United States.