This chapter discusses hospital transportation system. It will include transportation of patients, supplies, goods, personnel, equipments, linen, and food articles, the transportation system is not restricted to ambulances. It includes ambulances of all types, lifts, dumb waiters, trolleys, escalators, Lorries, trucks, etc. External transportation will include ambulances, relief van, train, ambulance train, car, rickshaws, bicycles, bullock cart, helicopter, aircrafts, horses, mules, manual laborers etc. There is no viable system has yet been developed to transport the critically ill patients from rural area to the referral centers. There should be well defined and demarcated area for parking of the ambulances in the hospital. Separate toilets for male and female visitors should be provided, as a good number of people visit the ambulance service department.