Military and emergency response remain inherently dangerous occupations that require the ability to accurately assess threats and make critical decisions under significant time pressures. The cognitive processes associated with these abilities are complex and have been the subject of several significant, albeit service specific studies. Here, we present an attempt at finding the commonalities in threat assessment, sense making, and critical decision-making for emergency response across police, military, ambulance, and fire services. Relevant research is identified and critically appraised through a systematic literature review of English-language studies published from January 2000 through July 2020 on threat assessment and critical decision-making theory in dynamic emergency service and military environments. A total of 10,084 titles and abstracts were reviewed, with 94 identified as suitable for inclusion in the study. We then present our findings focused on six lines of enquiry: Bibliometrics, Language, Situation Awareness, Critical Decision Making, Actions, and Evaluation. We then thematically analyse these findings to reveal the commonalities between the four services. Despite existing single or dual service studies in the field, this research is significant in that it is the first examine decision making and threat assessment theory across all four contexts of military, police, fire and ambulance services, but it is also the first to assess the state of knowledge and explore the extent that commonality exists and models or practices can be applied across each discipline. The results demonstrate all military and emergency services personnel apply both intuitive and formal decision-making processes, depending on multiple situational and individual factors. Institutional restriction of decision-making to a single process at the expense of the consideration of others, or the inappropriate training and application of otherwise appropriate decision-making processes in certain circumstances is likely to increase the potential for adverse outcomes, or at the very least restrict peak performance being achieved. The applications of the findings of the study not only extend to facilitating improved practice in each of the individual services examined, but provide a basis to assist future research, and contribute to the literature exploring threat assessment and decision making in dynamic contexts.