Fame Fire Company was one of the original fire companies formed in the early 1850's in the borough of Lewistown. FAME Fire Company with Henderson Fire Company covered Lewistown Borough and the surrounding communities. In 1923, Fame Fire Company first started transporting patients in a donated hearse. The Fame Fire Company Ambulance Division Incorporation was officially formed in 1928 to aid in the treatment and transport of sick and injured people to Lewistown Hospital. At this time they purchased their first ambulance which was a 1928 Willys Night. FAME's second ambulance was a 1929 Studebaker.

Fame Fire Company Ambulance Division was a volunteer organization from 1928 until 1988 when the first paid EMT's were hired to supplement the volunteer staff.

In 1989 Lewistown Hospital created what is now know as Medic 29. Medic 29 was the first ALS service in the area and provided paramedics on intercept units to supplement BLS units of Fame Fire Company and surrounding BLS ambulance companies in Mifflin and Juniata County.

On September 23, 1992 Fame Fire Company Ambulance Division Incorporated was reincorporated to become Fame Emergency Medical Services Incorporated and acted as a separate entity from the fire company. Fame EMS had two ambulances and was staffed by 4 paid EMT's supported by volunteers. They responded to approximately 2000 calls per year and covered Lewistown Borough, Juniata Terrace, and portions of Granville and Derry Township. During 1992 Fame EMS also converted from self dispatch to being dispatched by Mifflin County Communications.

In January of 1994, Fame EMS moved out of the fire station and into it's new and current building at 701 Valley Street. After moving, Fame EMS had a fleet of 3 ambulances and 5 paid EMT's supported by volunteers and responded to approximately 3100 calls. During 1994 Fame EMS was also licensed by Sevens Mountains Regional Council to provide advanced life support. On November 21, 1994 Fame EMS responded to it's first ALS call.

In 1996, due to a growing need to transport patients efficiently from the hospital to their homes and to doctors appointments, Fame EMS increased services to include wheelchair van transports.

In August 1999, Fame EMS expanded it's BLS coverage area to cover Yeagertown, Burnham, Decatur Township, and all of Derry Township.

In 2000, Fame EMS expanded it's ALS coverage to Yeagertown, Burnham, Decatur Township, and parts of Derry Township not previously covered. Fame EMS also put into service the first Rehabilitation Unit of it's kind in the county. The Rehabilitation Unit purpose is to aid local fire services with medical monitoring and rehabilitation services to firefighters during fire incidents. The Rehabilitation Unit is also equipped to aid in police incidents and search and rescue.

In 2003, construction was completed on a building expansion. The addition includes three additional vehicle bays and a state of the art training room.