M.A. (Clinical Psychology) / South African paramedics are thought to be exposed to a high number of critical incidents as compared to paramedics elsewhere (Ward, Lombard & Gwebushe, 2006). Therefore, South African paramedics are at particular risk of suffering from negative effects associated from the exposure to critical incidents. This study aimed to gain an in-depth understanding of the meaning which paramedics attach to the experience of “critical incidents” (Mitchell, 1983). This information may be beneficial for those working in Emergency Medical Services in South Africa to further understandings of paramedics’ experience of work related trauma. Five paramedics, sourced from both public and private ambulance service, between the ages of 27 and 36 years old, who have had between 8 to 12 years of working experience were interviewed regarding their lived experiences of critical incidents. The semi-structured interviews were transcribed and analysed based on the Interpretative Phenomenological Analysis (IPA) framework suggested by Smith and Osborn (2008). The analysis of each of the participant’s transcripts provided four master themes, some of which are supported by superordinate themes. The master themes are: 1) Experiencing the trauma of critical incidents, 2) Experiencing in the “World” of EMS, 3) Intrinsic factors and active attempts of coping with stress, and 4)Personal consequence of being a paramedic. For most of the participants, their narratives highlighted that the organisational variables were considered to be more important than the nature of the critical incidents they experienced. Critical incidents were deemed traumatic as there was a disparity between the participant’s expectations of what was expected and what they were confronted with in “reality”. In addition, the participants described forming an emotional bond with their patients or the patient’s family, which added to their distress. The participants’ narratives emphasised the importance of the role of the EMS organisation in influencing their experiences. Despite employing a number of coping strategies to mediate the effects of organisational as well as critical incident stress, the participants reported experiencing longterm negative psychological symptoms that have impacted on their personal and familial lives. These findings support the growing body of knowledge that demonstrates that organisational variables play an important role in either mediating or exacerbating posttrauma outcomes.