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Purpose: This study aimed to identify the effects of job insecurity and job engagement on turnover intention of paramedics who work in emergency medical institutions. Methods: From October 14 to 28, 2014, data were collected by structured questionnaires from 171 paramedics who were working in emergency medical institutions. The data were analyzed by using SPSS/WIN 21.0. Results: Of the 171 subjects, 57.3% were temporary employees, of whom 87.5% were working in regional emergency medical centers. The mean scores were 3.19 for job insecurity, 4.58 for job engagement, and 3.28 for turnover intention. The correlation between the variables showed that the higher the job insecurity of the participants, the higher their turnover intention (r = .397, p ＜.001). Moreover, the higher their job engagement, the lower their turnover intention (r = -.354, p ＜.001). The variable that most significantly affected turnover intention was job insecurity. The coefficient of determination (R2) of job insecurity and job engagement was 24.3%. Conclusion: A law should be enacted to involve paramedics as required personnel for emergency medical institutions in order to enhance the quality of emergency medical services and provide prompt and professional emergency medical services to emergency patients.