A description of recent developments in emergency medicine and prehosp
ital care in the new South Africa is detailed. As South Africa creates
a new integrated health care system with equal access for all citizen
s, expansion of emergency care services to previously disadvantaged po
pulations is occurring. To illustrate current disparities, a compariso
n of 2 regional systems of emergency medicine is included. The challen
ges involved and possible future directions in this effort are discuss
ed.