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Purpose: This study was conducted to identify the factors influencing performance confidence by knowledge and experience of respiratory-assistant therapy in paramedic students. Methods: A descriptive survey study used a convenience sample comprising 387 students from September 15 to October 31, 2016. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and regression analysis. Results: Knowledge was statistically significant by college(3-year), acquired certification, and observation experience in respiratory-assistant therapy. Performance confidence was statistically significant by sex, academic grade(3.0≤), acquired certification, and observation and performance experience in respiratory-assistant therapy. There was a significant correlation between knowledge and acquired certification, clinical practice, and major satisfaction. There was a significant correlation between performance confidence and acquired certification, clinical practice, major satisfaction, and knowledge. Regression analysis revealed that performance confidence accounted for 22.9% of the variance by academic grade(3.0∼3.99), acquired certification, and major satisfaction. Conclusion: For paramedic students in clinical practice and in-school classes, it is important to improve performance confidence by combining training instruction with experience and education of respiratory-assistant therapy.