Background: Because of the complexity, stressfulness, and the threatening nature of the working environment of prehospital Emergency medical Technicians (EMTs), they encounter many ethical challenges during making decisions and providing quick and accurate care to patients. The present study aimed to investigate the ethical challenges among prehospital EMTs. Materials and Methods: To review all published studies, we searched SID, Medlib, Iran Medex, Magiran, Web of Science, Medline, Google Scholar, CINAHL, PubMed, Ovid, and Scopus databases from 2000-18. The keywords were “ ethical challenges” , “ Emergency medical technicians” , and “ prehospital Emergency” . Results: According to the evaluation of the studies, the ethical challenge regarding prehospital emergencies included decision over dispatching an ambulance to the scene, cardiopulmonary resuscitation, triage in crisis and disaster, irrational interventions of the patient or patient’ s family, intervention in accordance with patient’ s informed consent, and safe driving. Conclusion: Considering the unique conditions of prehospital caring, identifying, and discovering the ethical conflicts in this field of the health care system and providing the appropriate solution are very important.