Citizens in Warren County voted to approve the formation of the Warren County Ambulance District on August 6, 1974. 1482 votes were cast for the establishment of the District and 225 against. The initial tax rate was $0.08 per $100 assessed valuation.

From February 22, 1975 through December 31, 1975, Douglas E Brown, owner of the Nieburg-Brown Funeral Home and Furniture Store, Wright City, Missouri, furnished the first ambulance service to the district.

From January 1, 1976 through December 31, 1976, the Board contracted with the Nieburg-Paul Mortuaries for ambulance service. A total of 357 ambulance transports were recorded.

From January 1, 1977 through December 31, 1977, the Board awarded the contract to B & P Transfer Company. The tax rate for the district was set at $0.08 per $100 assessed valuation for 1977. On August 18, 1977, the tax rate was increased from $0.08 to $0.15 per $100 assessed valuation.

From January 1, 1978 through December 31, 1979, Nieburg-Brown provided the ambulance service. Fred Pickens, President of Warco Emergency Medical Systems, was awarded the ambulance service contract for the calendar years of 1980 and 1981.

On February 3, 1981, the Warren County Ambulance District informed the Missouri Department of Health that the current contractor would not renew the contract for ambulance service. The Warren County Ambulance District filed a letter on intent to provide ambulance service. On June 16, 1981, an ambulance was ordered for the Warren County Ambulance District through the State Procurement Program at a cost of $11,649.50. The City of Warrenton constructed a 1,260 square foot building to house two (2) ambulances, living quarters for two (2) employees and an administrative office located at 713 Powell Street in Warrenton, MO.

On January 1, 1982, the Warren County Ambulance District started operations. A new tax rate of $0.27 was sent for the District, providing about $41,000.00 is tax revenue. During the first year of the District operating the service, they responded to a total of 562 calls.

During 1984, the District responded to 874 calls, a 56% increase from 1983.

In 1985, the District entered into an agreement to purchase the property at 713 Powell Street for $35,000.00, payable over 5 years. Due to the Hancock Amendment, the tax rate for 1985 was rolled back to $0.13 per $100 assessed valuation.

During 1986, a 1,764 square foot expansion (42' x 42") to the existing building was planned and put into effect. This expansion would house up to three ambulances and created two bedrooms, a medical storage area and laundry room.

In 1990 the District purchased two city lots in Wright City for future expansion in the eastern area of the district.

In 1991, an expansion to the base in Warrenton included two additional bedrooms, a bathroom and a two bay area, totalling 1,200 square foot. The total building is now 4,224 square foot. The final expansion on the building took place in 1988. Expanded office area totalling 504 square foot was added across the front of the building.

In September of 1997, the District opened Base 2 located at 111 South West Second Street in Wright City. The District purchased 4.35 acres from the Warrenton Fire Protection District in 1998 for the future relocation of the District's Headquarters. Plans for construction continued in the Spring of 1999, with construction on a new 10,000 square foot facility starting in the Fall of 1999.

On April 9, 2000, the new District Headquarters was dedicated to the Citizens of the Warren County Ambulance District. The current tax rate is $0.23 per $100 assessed valuation. A project of developing a Mass Casualty Incident (MCI) Trailer was undertaken during 2000 through a generous donation from a local citizen. The Warren County Ambulance District was privileged to provide the EMS support for Vice President Al Gore from October 15 to October 17, 2000 during his Presidential Debate preparation in Innsbrook.

In 200X, the citizens of the Warren County Ambulance District authorized the Board of Directors to pass a tax rate of $0.35 per $100 assessed valuation for the purpose of securing property for a second satellite facility, improve a salary and benefit package for the employees and upgrade the service by purchasing new cardiac monitors and laptop computer for patient care reporting. In 2005, the District purchased new Zoll cardiac monitors and laptop computers with the ImageTrend field bridge patient care reporting and the ImageTrend service bridge to transmit the patient reports directly to the Unit of Emergency Medical Services.

In 2006, the Board of Directors approved a six year strategic plan, taking into consideration the rapid growth projected for the area. In November of 2006, the district completed construction of a second satellite facility located at 26091 South Highway 47 serving the southern portions of the district south of Interstate 70. During 2006, the District responded to 2,733 calls.

In 2007, the district purchased a 60KW generator to supply Base One with power in the event of a power failure. The Warren County Ambulance District worked with the Region C Homeland Security Oversight Committee in securing an additional portable generator, an inflatable tent and mobile response unit. Six other counties in the Region C area obtained similar equipment that can be within the Region C area in the event of a disaster or other emergencies.