Recently, the disaster emergency medical system (DEMS) has been considered an important component of social safety, since the incidence of various kinds of disasters such as man-made disasters, biological disasters, chemical disasters and nuclear disasters are increasing each year. To minimize the mortality of emergency patients and mass casualties, emergency physicians should directly participate in both emergency care and DEMS. However, most primary emergency care in hospitals depends on residents of emergency medicine, especially at night and holidays, and few certified emergency physicians work at emergency control centers, military hospitals, and rural hospitals that are part of the DEMS. To strengthen DEMS and improve the quality of emergency care, emergency physicians are needed at emergency centers at all times to provide emergency care, and to maintain communication with the DEMS offices that are outside of hospitals. To make DEMS cost-effective, the governments should unify the 119 and 1339 emergency call centers, and also establish a plan for integrating the DEMS components of the Ministry of Health and Welfare, National Emergency Management Agency, and Military Services. By securing the financial support plan for emergency centers, the survival rate of emergency patients and disaster victims will be improved.