Finland is a comparatively large and sparsely populated country in Northern Europe. As such, providing efficient emergency medical services (EMS), particularly in remote areas, is challenging. There are 22 hospital districts in Finland, all offering 24/7 trauma care, and five university hospitals within these 22 districts. Each district is responsible for organising EMS in its area, either independently, together with the local fire and rescue services or by buying in the service from private EMS providers. Using Lapland as an example of a highly rural area—where, for example, the distance from the only hospital in Rovaniemi to the northernmost part of the district is over 400 km—the present article provides a concise description of the challenges and solutions involved in providing EMS in sparsely populated areas and illustrates how Finland has built up an EMS system with limited resources.