When emergency vehicle collisions occur, especially at speed with lights and siren, they tend to evoke heightened media attention as well as public concern and interest. While these concerns are understandable given the sheer size and mass of heavy emergency vehicles (i.e., fire/ladder trucks) relative to much lighter, non-emergency vehicles, such concerns must be placed into context. Emergency vehicle crashes may potentially lead to tragic outcomes, especially when heavy vehicles traveling at speed are involved. However, accidents involving emergency vehicles in BC are infrequent; most are of a minor nature and incur property damage only. The intent of this study is to look at the evidence related to the current discussion around emergency vehicle crashes. These crashes are often linked to casualties, specifically fatalities or injuries. In regards to certain types of emergency vehicles such as fire/ladder trucks operating in Greater Vancouver, precisely the kind of vehicle that can inflict extensive damage in busy urban settings, it should be noted that such crashes are extremely rare. Given the high profile of emergency vehicle crashes, together with 24/7 news coverage and the prevalence of social media, they may appear more common to the public than they actually are.