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Agriculture has among the highest numbers and rates of fatal and non-fatal traumatic injuries in the U.S. Surveillance is an integral part of injury prevention. However, traditional sources of surveillance data are incomplete and inaccurate in describing agricultural injuries. The goals of this research are to describe acute, traumatic farm injuries in Ohio utilizing the Ohio EMS prehospital (ambulance run) database, and to explore the databases utility in agricultural injury surveillance. Ohio mandates reporting of responses to every call for emergency medical services (EMS) in the state. A dataset containing every transported injury case from 2003-2006 was obtained. A descriptive analysis of farm injuries was conducted and compared to existing surveillance sources. Of the total transported injuries, 15% (1714 injured individuals) came from farms. Falls were the most common cause of injury in all age groups except ages 15-24, in which off-road vehicles were most common. Other leading causes include ridden animal, machinery, and caused by animal. These results are similar to other data sources. Strengths of EMS databases include mandatory reporting, low expense, and lack of need for employer or worker reporting. They may be used to look at injury severity, quality of acute care, resource allocation, and to assess the need for specialized training of EMS personnel. Limitations are lack of specificity for work-related agricultural injuries and variation in definitions of data elements. EMS prehospital databases are an important source of data for agricultural injury surveillance.