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Emergency medical services (EMS) providers face elevated burnout risk due to job-related stressors, organizational challenges, and physical and emotional demands. Stigma and limited support further endanger EMS providers’ wellbeing. Burnout not only affects providers but can also compromise care recipients, and system sustainability. Research on EMS providers’ wellbeing remains limited and subject to moderate generalisability. This study examines the prevalence of burnout, depression, suicidal thoughts, and turnover intention among Swiss EMS providers, offering a national multicentre perspective across all 26 cantons plus Liechtenstein. A web-based survey was distributed to all active EMS providers in Switzerland and Liechtenstein between May and June 2024. The questionnaire included validated patient-reported outcome measures of burnout (Maslach Burnout Inventory (MBI) and Copenhagen Burnout Inventory (CBI)), and depression (Patient Health Questionnaire-9). The primary outcome was the prevalence of burnout, and secondary outcomes were prevalences of depression, suicidal thoughts (measured using two dedicated additional questions) and turnover intention (evaluated with a specific frequency-based question). Multivariable logistic regressions were run separately for MBI and CBI outcomes to identify burnout determinants. Of 3669 eligible providers, 1485 completed the questionnaire (40.5%). Burnout prevalence was 43.4% (MBI) and 36.5% (CBI), with regional variations. Night shift frequency was consistently associated with increased burnout risk across both MBI and CBI in a dose-dependent manner. Age, gender, professional title categorized as “Other”, canton of work and childlessness, were associated with burnout in a scale-specific manner. Turnover intention was high, with 67.7% of respondents reporting having considered leaving their job at least once. A total of 13.4% of participants reported moderate to severe depression, and 10.2% indicated they had contemplated suicide, of which 46.7% within the past year. Burnout is a significant concern among Swiss EMS providers. Night shift frequency emerged as the only predictor consistently associated with burnout, showing a dose-dependent effect, and highlighting it as a priority target for intervention. Scale-specific associations reflect the multidimensional nature of burnout. These findings underscore the urgent need for targeted, evidence-based interventions to protect EMS providers’ wellbeing and mitigate cascading effects on prehospital care quality, safety, and the sustainability of the healthcare system.