The National Quality Forum has a list of “Never Events” that should simply never happen in healthcare - actions that are clearly identifiable, serious, and preventable. This list of 29 serious preventable events has some application to the EMS profession, but because of our unique environment of care, some of these do not apply while others require some modification. We will review the definition of a “Never Event” in the EMS profession and contrast these events with “best practices.” We will then discuss a series of EMS-specific Never Events in the clinical, operational, and legal segments of our system, and for each one we will clearly define the event and the mandatory preventative measures that can help prevent them from occurring. This lecture is a unique look at a major safety aspect of EMS as part of healthcare that we do not typically focus on. Attendees will take home real-world tools to put into action in their systems to help improve patient care and reduce these preventable major safety events.