A medical call, by a wide margin. In U.S. Fire Administration (USFA) data for 2024, fires are 3.7 out of every 100 responses, while the category called EMS and Rescue is 65.1.
The short answer
USFA’s statistics page says it plainly: “Emergency medical services (EMS) calls are by far the leading incident type that U.S. fire departments respond to.” Its 2024 chart puts EMS and Rescue at 65.1, False alarms at 8.0 and Fires at 3.7. We read those numbers as percent of responses. The chart does not print a unit, and the section on what this does not tell you shows our reasons.
“Medical call” is our plain-English label. USFA’s category is EMS and Rescue, and it covers more than illness. In its 2020 report, within that category, EMS calls were 67.8 percent, medical assists 13.9 percent and motor vehicle accidents with injuries 4.8 percent.
The scene
Imagine you are half a block from the station when the bay door starts to rise.
The truck eases out, red and polished, with the kind of presence that makes parked cars look shy. You stop on the sidewalk, coffee sloshing a little. The words on the side settle the matter before your brain does: fire truck, therefore fire. It turns the corner, lights flicking across a laundromat window, and is gone before you finish the thought.
Names are excellent at marketing and less reliable at accounting.
The rounds
Here is the whole USFA 2024 mix, with the figures exactly as the chart prints them, read as percent of responses.
| USFA 2024 category | Percent of responses (as we read it) |
|---|---|
| EMS and Rescue | 65.1 |
| Good intent | 11.8 |
| False alarms | 8.0 |
| Service calls | 7.7 |
| Fires | 3.7 |
| All other | 3.7 |
Round one goes to the medical call, and it is not close. EMS and Rescue is 65.1, which is nearly two thirds of the chart.
Round two is the twist. If you expected the runner-up to be fire, the table disagrees. False alarms are 8.0 and fires are 3.7, so in the national response mix false alarms outnumber fires.
Fires tie with “All other” at 3.7. That is how the chart prints it, not a typo here. A joke, not a finding: call it an ambulance with a ladder.
Why we guess wrong
One plausible reason is the name. “Fire truck” points your imagination in one direction before any statistics get a vote.
Another likely reason is that fire makes a better story. A fire is one vivid noun. “EMS and Rescue” is an administrative umbrella, useful for counting and poor at starring in a trailer.
Either way, the small category gets the big cultural footprint.
From the table to out of 100
Picture the chart as 100 departures. Out of 100 responses in the USFA 2024 mix, about 65 are EMS and Rescue, 8 are false alarms and about 4 are fires.
Flip the fire number over and 100 divided by 3.7 is about 27, so about 1 response in 27 is a fire. For false alarms against fires, 8.0 divided by 3.7 is 2.16, so about 2 false alarms for every fire. We rounded once, at the end.
What this does not tell you
These are national figures, not a forecast for your station, your town or your block.
They come from departments reporting to the National Fire Incident Reporting System (NFIRS): 22,582 of them in 2024, according to USFA. USFA also says “The NFIRS is not a complete census of reported fires in the United States. It comprises about 70% of all fire incidents that occur annually.”
The unit is the other caveat. The visible 2024 chart prints no unit and no percent sign. We read it as percent of responses for three reasons. First, the six values add to 100.0. Second, USFA’s 2020 report uses the same categories and says: “Only 4% of all reported fire department runs were fire related.” Third, USFA’s NFIRS page says departments reported over 33.3 million responses in 2024, including nearly 1.2 million fire responses, and 1.2 divided by 33.3 is about 3.6 percent, close to the 3.7 shown. That is strong evidence, not a printed label.
Finally, “EMS and Rescue,” “False alarms” and “Fires” are USFA’s categories, and we do not define them beyond their names.
Sources and method
- USFA, Statistics page, “U.S. fire department responses (2024)”, source NFIRS 5.0: https://www.usfa.fema.gov/statistics/ (the 2024 table and the EMS statement)
- USFA, About NFIRS, 2024 NFIRS Public Data Release figures: https://www.usfa.fema.gov/nfirs/about/ (reporting departments, response counts, 70 percent statement)
- USFA, Topical Fire Report Vol. 22, Issue 1, “Fire Department Overall Run Profile as Reported to the National Fire Incident Reporting System (2020)”, June 2022: https://www.usfa.fema.gov/statistics/reports/firefighters-departments/fire-department-run-profile-v22i1.html (2020 percentages and the EMS breakdown)
The ratios are our arithmetic on those figures. The 2020 numbers support the method and are not part of the 2024 answer.
Last checked and corrections
Last checked: October 16, 2026. If USFA updates the 2024 statistics page or labels the chart, we will update this piece.
For now, keep one number: fires are 3.7 out of every 100 responses.