Objective. To describe the EMS response to a large-scale shooting incident involving military-style weapons. Methods. Descriptive review. Results. Twenty ambulances, nine engine companies, and three helicopters responded to this incident. Ten police officers and nine civilians were wounded, all of whom required transport to nearby hospitals. Two gunmen were shot and pronounced dead at the scene. No EMS personnel were injured. Conclusion. Incidents involving military-style weapons pose a unique challenge for prehospital care providers who must care for injured civilians and law enforcement personnel while maintaining their own safety. Use of the Incident Command System, establishment of a liaison with law enforcement, and the provision of protective gear for EMS personnel are vital to effectively and safely manage these types of incidents.