Prehospital emergencymedical Care (EMC) is a critical service in disaster management. The aim of this study was to explore the challenges of prehospital emergencymedical services (EMS) during disaster response in Iran. Methods: A qualitative study was conducted from April 2015 toMarch 2017. Data were collected through in-depth, semi-structured interviews with 23 experienced individuals in the field of disaster that were selected using purposeful sampling. Data were analyzed using content analysis approach. Results: Fifteen subthemes and the following six themes emerged in the analysis: challenges related to people, challenges related to infrastructure, challenges related to information management systems, challenges related to staff, challenges related to managerial issues and challenges related to medical care. Conclusion: Iran’ s prehospital EMS has been chaotic in past disasters. Improvement of this process needs infrastructure reform, planning, staff training and public education.