The Monona Fire Department added an Emergency Medical Services (EMS) division in 1978 and upgraded that division from a basic EMS level to paramedic level with advanced life support capabilities in 2013. Monona residents now have the highest level of emergency services available in Dane County. The Monona Fire Department responded to more than 1,200 EMS calls in 2020.

Monona Fire Department currently employs nine full-time firefighter/paramedics as well as six part-time firefighter/paramedics and 13 POC / POP (volunteer) EMS providers of all levels. The full-time staff work 48-hour shifts (48 hours on / 96 hours off) in teams of three, providing a minimum of two certified paramedics on-duty in Monona at all times. While all of our apparatus have basic EMS capabilities, we also maintain two ambulances with advanced life support capabilities. The primary ambulance, Medic 60, is staffed 24 hours a day, 7 days a week by two paramedics.  The second ambulance, Medic 62, is used when staffing allows, or when Medic 60 is on a call or out for maintenance. Monona Fire Department is also a member of an advanced life support consortium. This means that Monona Fire is called to respond to other neighborhoods or communities if it is the closest available unit with advanced life support capabilities.