Cardiovascular disease is a major contributor to the health inequities between Māori and non-Māori. Reasons are multifactorial and not all differences can be attributed to modifiable risk factors or social circumstances. Research shows that Māori with ACS: often delay calling the emergency number 111; present to their general practitioner or an accident and emergency department, delaying access to hospital; and are less likely to go to the hospital by ambulance. Thus, understanding access to and experiences when utilising pre-hospital care is important. Despite extensive literature demonstrating negative experiences and poor-quality healthcare for Māori, there is very little in the pre-hospital context. This study aimed to explore experiences of cultural (un)safety in acute pre-hospital care by paramedics for cardiac symptoms. A key objective was to enable ambulance services to better respond to Māori.