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Background Prehospital care, starting from the patient’s first contact with the emergency medical call centre and including medical care provided in the ambulance, is part of the continuum of care defined as emergency medicine (EM). Sweden has a network of emergency medical call centres that are all reached by one telephone number and staffed by nurses, among other personnel. Objective This review presents a summary of the prehospital care systems currently in place in Sweden, the role of the physician and the future challenges in this evolving and important field. Results and conclusions Since 2005, the presence of registered nurses in ambulance teams has become a requirement. This proved to be a turning point in the development of advanced care in the prehospital setting in Sweden. Due to overcrowding in emergency departments, the ambulance services work to steer patients from the ambulance directly to definitive care. Although there are limited numbers of physicians in the prehospital setting today, this should change as the specialty of EM grows stronger.