The introduction of an ambulance service for the hospital came about after many meetings between the Regents of Long Island College Hospital and the medical staff. The cases of people that succumbed to traumatic injuries before medical attention was delivered increased annually. The concept of sending a team of physicians out to the accident scenes to provide immediate medical care was not looked upon favorably at first. The technological advances of pain management, extremity fixation splints, and tourniquets helped stabilize patients long enough to get them to definitive care. After a long and arduous vote, the regents of Long Island College Hospital approved the creation of an ambulance service.

In 1873, the Long Island College Hospital Ambulance Department was started on August 20 and was stationed in the stable on the north side of Pacific Street.

In 1874, the administration approved the addition of a second ambulance and was stationed at Eastern District Hospital (Brooklyn Hospital).

In 1983, the department introduced a new concept to provide better ambulance service at Long Island College Hospital, introduction of Paramedics. One of the ambulances now provided advanced life support while the other provided basic life support.

In 1988, the administration decided to cut one of the ambulances due to severe financial problems. The basic life support unit (36F) was cut from service while the advanced life support unit (36X) maintained.

In 1996, FDNY took over the role of lead agency for all 911 ambulance services in NYC. Units were rearranged and placed into a battalion based system to mimic the Fire Department.

In 1998, the administration looked to cut the ambulance service and reduce the unit altogether. The ambulance department was reviewed and was given 90 days to execute a strategy to maintain the service.

In 1999, the administration approved the addition of a second advanced life support unit (32X) to the current deployment.

In 2003, the administration approved the addition of a single basic life support unit (32F) to the current deployment.

In 2004, the administration approved the addition of a second basic life support unit (32D) to the current deployment.

In 2005, the administration of the hospital approved the addition of a third Advanced Life Support unit (32T) to provide private ambulance services.

2006, the administration of the hospital approved a third Basic Life Support unit (32B) to provide private ambulance services.

2007, the administration of the hospital approved a fourth Basic Life Support unit (32K) to provide private ambulance services.