iarjsIARJSIARJS2789-610210.47310/iarjs.2025.v05i01.016Emergency? Call Whom? A Study on Public Awareness and Utilization of Emergency Health Services in Himachal PradeshBackground: Emergency health services, such as the 108-ambulance service, are vital for timely intervention in medical crises, yet low awareness, inadequate first-aid knowledge, and care delays persist in rural India, particularly in Himachal Pradesh’s challenging terrain. This study aimed to evaluate public awareness and utilization of emergency health services, focusing on rural communities, to identify knowledge gaps and barriers. Materials and Methods: A descriptive, cross-sectional online survey was conducted from January to February 2025, targeting adults aged 18–60 years in Himachal Pradesh. A bilingual (Hindi/English) questionnaire, hosted on Google Forms, assessed socio-demographic factors, knowledge of the  108-ambulance service, first-aid practices, care-seeking behaviors, and barriers. Using convenience sampling, 550 participants completed the survey. Data were analyzed with IBM SPSS Statistics v27.0, with knowledge scores categorized as Very Good (≥80%), Good (60–79%), Fair (40–59%), and Poor (<40%). Results: Participants, primarily aged 18–35 years (72.9%) and female (54.9%), showed moderate awareness: 80.0% recognized the 108 service’s free transport, 83.1% identified its on-site care capability, and 85.1% noted awareness as a barrier. Gaps existed in immediate 108 calls for injuries (60.0%), non-emergency unconsciousness (61.1%), and care delay risks (63.5%). Knowledge levels were Very Good (28.0%), Good (45.8%), Fair (20.2%), and Poor (6.0%). Limited emergency service access (32.7%) highlighted rural challenges. Conclusion: While awareness of emergency health services is improving, knowledge gaps and access barriers persist in Himachal Pradesh. Targeted education, first-aid training, and infrastructure improvements are crucial to enhancing timely care.