Aim: The aim of this study was to evaluate the use of pre-hospital emergency 112 ambulance services in Karabuk city. Material and Metod: This discriptive study all 112 emergency service utilizations were performed retrospectivly between 01 January-31 December 2013. For this purpose the forms of emergency calls were evalatued. Data on demografics, reasons for using ambulance services, preliminary diagnosis, the transport time that emergency medical team to the scene of event, emergency service diagnosis and reasons for to out of province medical referrals were collected from 112 call forms and emergency service charts. Results: During the study period, 21.878 patients have benefited from the 112 emergency ambulance services in Karabuk city. Of these, trauma (by15.3%) were the most common reason fort the 112 emergency calls, followed by cardiovascular diseases (11,3%). Transport time was less than 10 minutes in 67.8% of the cases and 30 minutes in 95% of the cases, respectively. In the first half hour 95% of the cases were reached. on out-of-province. Ambulances were used by the most reasons of the non-emergency(n=103) and the second reasons of cardiac patients(n=52) on out-of-province Discussion: Traumas and cardiovascular diseases are the leading causes of 112 calls in Karabuk city. Most of the out-of-province referrals were due to non-emergent conditions or cardiovascular diseases. Our results highlight the importance of appropriate use of 112 emergency ambulance services. Shipped out of the province instead of ambulances for non-emergency patient should be used transport vehicles. Establishment of cardiac catheterization and open-heart surgery services will reduce out-of-province referrals.