Background Since its development in the 1970s, the paramedic profession has tried to expend its traditional role of providing prehospital emergency care in ambulances into new fields of practice (e.g. community care). Paramedics in Israel are employed almost exclusively in the emergency medical services (EMS). Similar to other countries, the manpower shortage in the Israeli health system forced policy-makers to consider the expansion of traditional roles of various healthcare professions including paramedics.Objectives This presentation seeks to: (1) map the current situation and challenges facing paramedics in Israel; (2) examine paramedics' professional status among policy-makers; and (3) examine the best way to integrate paramedics in the Israeli health-system.Methods Qualitative interviews were conducted with 20 senior policy-makers in the Israeli EMS system, Academia, Health Ministry, and military. A policy analysis of documents, laws, regulations, and public media was conducted.Results The Ministry of Health in Israel did not play a significant role in the regulation of the profession. Nevertheless, according to the interviewees, paramedics have gained considerable professional recognition among policy-makers, healthcare professionals, and the general public. Following the medical manpower crisis that is evolving in Israel, and the trends that are common in many western countries of expanding the traditional roles of allied health professions, most policy-makers in Israel see the paramedic role evolving into new field of practice. According to policy-makers, legislators, and EMS officials, the major challenges that the paramedic profession faces deal with legislative and professional (mainly academization) issues.Conclusions The paramedic profession must adapt itself to the new medical environment. More research should be conducted to build a model, adapted for different local national context, to expand the traditional role of paramedics. This will influence training, research and policy-making regarding the paramedic profession, and will change the traditional professional medical borders.