The Collinsville Fire Department provides emergency medical services to the City of Collinsville and the adjacent Collinsville Fire Protection District. The department responds to an average of nearly 2200 EMS calls per year, or two thirds of its total call volume. Typical calls may be for persons suffering from sudden onset medical conditions such as shortness of breath, chest pain, cardiac arrest or stroke. Calls are also received for persons with ongoing medical conditions or for those who cannot be safely moved by family members. Falls and motor vehicle accidents likewise prompt many EMS responses.

Two or three firefighter/paramedics respond to most EMS incidents in one of three department ALS ambulances, and/or two ALS fire engines.

The Fire Department evaluates and treats patients prior to and during transport to the hospital. In order to keep units available for emergency calls, the Fire Department does not provide non-emergency transports, such as to scheduled appointments or to nursing homes or back home from a hospital. Such services must be provided by private ambulance companies.

The Collinsville Fire Department is now in its 45th year of EMS transport service to the residents of Collinsville.