Objective:To estimate the incident rate of the hypoglycemic patients transported by EMS and to evaluate EMS primary impression for these patients. Methods and Design: Retrospective, observational study was based on data for 150,563 SAUDI RED CRESENT AUTHORITY Transported Patients during 2017. Subjects were defined as having Hypoglycemia if EMS personnel recorded a primary impression of hypoglycemia or low blood glucose (<60 mg/dL Or "unspecified low"). The outcome of interest was patient transport or non-transport to an emergency department or other care settings. Results:Among 150,563 eligible encounters, 1984(1.29%) were diagnosed with hypoglycemia, of which 536 (27%) were not transported. Nontransported was more likely among male adult patients age (40-59), initial blood glucose <60 mg/dl or EMS arrival time midnight -6 A.M. Conclusion: A low rate of the non-transported patient to ED, Imperfect agreement between a primary impression of hypoglycemia and documented low blood glucose.