In 2015-2030, Thailand is aged society, and in the next 10 years, Thailand will become completed aged society. Elderly population will increase rapidly. This events affect emergency medical services (EMS) and hospital capacity to support emergency patients. Descriptive study design was employed. Six hundred elderly people, who used EMS in six months before data collection in four provinces, were interviewed. The results showed that in the past 6 months, older adult participants were most once required the EMS, and mostly caused by emergency illness and accident. The overall EMS satisfaction was responded at high level. Less than half of the sample had overall EMS perception at a high level. Needs for the overall EMS are at high level. Policy of emergency medicine for elderly people showed that all agencies had no specific policy for elderly people. EMS procedures (star of life) indicated that; 1) Detection: Causes of using EMS of elderly people were an accident at home, sepsis, hypoglycemia, dyspnea, etc. The witness were elderly people themselves, family members, and neighborhood. 2) Reporting: About 80 percent called the local authorities for help. They reached home quickly and did not ask a lot because elderly people used the service regularly. 3) Response: If the victim was at home, outside township, within area of responsibility, duration from notification to the scene was fast, not more than 8 minutes (if notified to the local authorities directly). If the victim was in urban area, duration could not specify. It depended on the traffic. 4) On scene care: Most of basic care for patients was first aid and then the patients was taken to the hospital as soon as possible. 5) Care in transit: Transporting elderly patients was not harmful to the patient. The ambulance in FR level, spinal board was used for moving because it was the only one instrument that can transport patients. 6) Transfer to the definitive care: EMS personnel coordinated to the hospital to transfer the patient. Thus, the hospital prepared the accident and emergency room for patients. EMS personnel judged to transfer the patients to the nearest hospital. However, it depended on the severity of the patient. Also, there was cousins in the ambulance. Patient was assessed vital sign periodically. EMS personnel talk to encouraging patients and cousins. 7) Services at emergency room of the hospital: Elderly patient was admitted by the system based on the severity, without the express track for the elderly. The results of this study will be the inputs for further development of emergency medical services system for elderly people, in line with the problems and needs efficiently.