San Francisco firefighters and paramedics rescue a man. A paramedic convention brings John and Roy back to San Francisco. While attending a picnic, SF firefighters and paramedics are called back to work for a mutual aid response in Marin County. John and Roy tag along on a rescue.

Gage and DeSoto travel to San Francisco, where they observe some topnotch women paramedics in action during major rescue missions. An injured worker is stranded on the Golden Gate bridge. Ambulance squads treat a heart attack victim at a dance bar and an epileptic at a coffee shop. A bad driver causes a traffic accident involving an ambulance carrying the heart patient, resulting in his death and five other injuries. Johnny dates a nurse interested in a long-term relationship. Careless workers and deadly chemicals combine to spark an explosive fire at a pier on the Embarcadero.

When John Gage and Roy DeSoto are both promoted to Captain, they reminisce about their years working together, along with Dixie and Dr. Early, at Rampart. Flash-back sequences include the rescue of airplane passengers after a crash-landing, a potential suicide threatening to leap from a crane tower, and a girl whose toe is stuck in a faucet.

John and Roy are sent to Seattle to study the techniques used there. A skydiver jumps off the Space Needle, a worker is trapped at the top of the Kingdome, and a fuel pumper mistakenly loads a ferry with gasoline instead of diesel fuel, which sets the ferry on fire in the middle of the Elliott Bay.

Squad 51 C-shift paramedics rescue a stuntman from a tower. Johnny and Roy respond to treat the injured child of a fireman's widow. A small plane and a chartered jetliner collide in midair, landing in a residential neighborhood, trapping Johnny and Roy. Station 18 leads a massive response from Battalion 14 and the Compton Fire Department. Dr. Morton heads up a triage team from Rampart. Multiple rescues include passengers from both planes and people in the subdivision. Dixie and Dr. Early perform brain surgery on the injured child. An elderly man's dog leads Chief McConnike to its owner. This movie marks the last appearance of the Squad 51 vehicle, as it is apparently buried in, and destroyed by, debris from the plane crash.

In a plot derived from The Towering Inferno, a high-rise building fire sparked by a carelessly thrown cigarette brings a multi-alarm response from Station 110, assisted by Squad 51. The fire traps several employees, including an office manager (Linda Gray) and her assistant (Anne Lockhart), who is engaged to one of the Squad 110 paramedics. Dr. Brackett leads a triage team from Rampart in a nearby garage. The Coast Guard helicopter is brought in to evacuate the trapped individuals. Dixie and Dr. Early handle the influx of patients at Rampart; while Roy and Johnny extricate themselves from a broken elevator, they also have to rescue an injured firefighter captain from an elevator shaft.

Johnny tries to create his own TV game show. The firemen (in the field) assist an elderly musician experiencing heart trouble, Dixie explains to Lt. Crockett about the patient's diagnosis (in the hospital). Then, an auto accident with three injuries caused by running a stop sign, and a tightrope walker gets stuck between two buildings.

John gets jealous when Brice is on the news, then their "favorite paramedic" leads another paramedic meeting in his own parliamentary way. Later, their Squad has to rescue Brice from a fire. The firefighters rescue a man's daughter from under a backhoe–then the father goes into cardiac arrest. Drs. Brackett and Morton treat a boy who accidentally shot himself with a BB gun and required a tracheotomy.

Capt. Stanley is in a foul mood and thinks he has arthritis, it takes Roy to talk to Dr. Brackett for information on his captain's arthritis. Roy and John help a man whose fingers are caught in a garage door opener, then a woman who passes out from inhaling contents from an aerosol can and has an auto accident. Dixie, Drs. Brackett and Early treat a woman, who underwent botched plastic surgery. John tests a new type of rope, which fails, and assist victims of a two-alarm fire at an oil refinery.

Capt. Stanley is worried his Chief's exam will be sabotaged by the current Chief, who has a past beef with Stanley. A soap opera doctor has real mono and causes drama both on-set with John and Roy, and at Rampart with Dixie and Dr. Early. Also, Dr. Brackett observes from Dixie that the producer is filming a hospital room with an ill patient, Brackett confronts with producer, before he seriously asks everyone to leave. John and Roy are stuck in an elevator with a retired doctor who has a self-diagnosed (and correct, as it turned out) aortic aneurysm.

Roy and John are trapped at Station 86 due to the only bridge in and out being washed away due to continuous rain storms, which ruins John's date plans, after Dixie got him to call his girlfriend. Since they are the only Squad in the area, they help two victims of an auto accident, then a child suffering from asthmatic bronchitis, an elderly woman with a hip injury and a man with cardiac problems. A psychiatrist aids the paramedics until Copter 15 transports the victims to the hospital, but a power failure causes issues. Dr. Morton accompanies the paramedics back to Station 86, where they respond to an auto accident with multiple injuries.

Charlie stores his speedboat he's trying to sell at the station; the firemen decide to chip in to buy it. Roy & John are medi-vac'd via Coast Guard helicopter to rescue two boaters from Catalina Island. The firemen help a bookie who is having a heart attack trying to answer dozens of ringing phones, before Dr. Brackett and Dixie treat him, later a lab explosion of Sodium azide starts a fire at Rampart, injuring several people, including Dixie, who burns herself.

The Station 51 basketball team qualifies for the semi-finals. The paramedics rescue victims at a gas explosion. While at basketball practice, the firemen treat an injured gymnast. The night before the big game the firemen get very little sleep: they respond to a number of emergencies, including a workman trapped at a studio.

Responding to a man with back pain, Roy and Johnny question Dixie about the over-cautious Dr. Morton's judgment in handling patients. A man comes into Rampart with a phosphorous burns on his arm, later a young boy is brought in after being hit in the head by a baseball, before Dixie and Dr. Brackett talk to the boy's coach. The paramedics help a man with trouble breathing, then his neighbor nearly drowns in a hot tub while the paramedics do an IV on the first victim. LASD officer Vince is involved in a traffic accident which leaves one man dead and two injured, including Vince, who begins pointing his loaded gun at John.

Roy is not looking forward to the annual visit from his mother-in-law. The paramedics assist two victims of an auto accident. Drs. Brackett and Early both argue about attending a convention in Acapulco; Dixie must encourage Dr. Brackett to go there with Dr. Early. An elderly man suffers stomach pains from drinking an elixir made from 50% alcohol, who refuses to listen to Dr. Early's orders, until both he (Early) and Dixie had told him to do exactly as he said. A candy striper carelessly places a bottle of alcohol above a clock radio which spills out, and the ensuing fire sends the patient in the room into respiratory arrest. A boy's model rocket sparks a house fire, with the dispatch process shown in some detail.

A sporadic electrical short plagues the squad but Roy and John are convinced they can fix it. A back-to-nature couple is ordered to cut back on their shrubbery; the wife is discovered to have a variant of anthrax. The paramedics rescue a man trapped at the top of a tower.

Capt. Stanley is unnerved that his former captain is now his Battalion Chief, and the station is concerned about his increasing paranoia. Chet tries to get Henry off the station couch into a doghouse. The carelessness of a gas station owner and attendant, as well as an angry driver leads to a fire. Dr. Brackett becomes increasingly angry at a new hospital administrator, constantly moving meetings around. A young wife accidentally shoots her older husband in the chest with a nail gun, while the doctors are treating him, Dixie prevents his young wife from seeing him. The firemen have to break up two clowns fighting at a ice rink and rescue two young girls whose car slid off the freeway and crashed into a truck loaded with pesticides.

The firemen assist a man with chest pains (and a young man who gets trapped trying to help him) while stuck on a ferris wheel. Roy & John are scheduled to appear on TV to discuss fire prevention, then help a child who swallowed parathion, and Dr. Brackett speaks with both parents about how their son got into the illegal pesticide, while Dixie treats a woman. During their TV appearance Roy and John become stars of a real-life emergency when a stagehand gets a electric shock from a live wire.

Dixie stops by Station 51 and Johnny is unable to sell her tickets to the Firemen's Picnic, where the top seller gets a trip to Las Vegas. The firemen respond to a traffic accident that Dr. Brackett is involved in which resulted in one death, for which Brackett blames himself, and he refuses Dixie's requests to rest. When the squad breaks down in an alley, they find themselves in an undercover operation with the police and aid a detective suffering from an angina attack. Later the firemen rescue two victims of a dock fire complicated by a box car full of flammable ammonia.

Capt. Stanley assigns Chet and Marco to fix numerous incident reports rejected by the computer. A man runs his car into a fire hydrant; when leaves his son alone to call for help (because the son wanted to "watch the water") the son nearly drowns by falling into a storm drain. In a complicated issue for Squad 51 to get the supplies, Dixie announces to Johnny, Rampart has a supply nurse, who puts Roy and Johnny, in an intolerable situation. The paramedics help a college janitor with stomach pains after drinking Mesoptamia-era wine and two people trapped in a warehouse fire.

While on vacation in a rural county, John and Roy help a local sheriff in emergencies and setting up a local emergency medical service.

The county payroll computer erroneously sends John a paycheck for $5900 instead of $590, and vows to return his incorrect check only when the county sends him a correct check, he then asks Dixie to use the hospital's phone to justify his situation. The firemen aid a homeless person who is accidentally crushed in a car at a junkyard, a man injured by the family dog (who gives Roy & John fits, including sending one of them into the pool), and two workers caught on a scaffold.

The firemen plan to celebrate the imminent retirement of a martinet captain with a party, under the guise of throwing a farewell dinner. A model in a bear suit suffers from heat stroke during a promotion stunt. A bizarre family believes their sleeping mother is dead. The firemen rescue CHP officers from a helicopter.

Roy and John are concerned about their Paramedic re-certification exam, Dixie asks Dr. Brackett to put together the exam, part-way. Molly, a fireman's widow, calls for help for her daughter, Jeanine, who got her head stuck in a table, and John is concerned about her calling them for minor things, until Jeanine has a really bad fall. An accident on a movie set turns deadly.

Roy and Johnny are asked to be part of a paramedic advisory committee, which also includes their least favorite paramedic, Craig Brice, who proceeds to conduct the meeting formally under parliamentary procedures, a conversation in which Dixie observes from Roy and Johnny, who tells them to learn more. A vehicle accident injures two line workers, one severe enough to require a tracheotomy which Dixie, Drs. Brackett and Early perform. The firefighters rescue a stunt climber from the side of a building.

The firemen walk in to a guest–a droopy-eyed dog–and he becomes the new mascot named "Henry;" he replaces Boot, who had died. The firefighters respond to an industrial fire and check a Top Secret room for victims–and a lot of questions from the employees about the contents of the room. "Therapeutic arguing" between a married couple leads to escalating violence and worsening injuries to both parties, and John is trapped in a cave-in trying to rescue two injured workers.

When Roy is unable to decide where to go on vacation, Dixie finds the perfect vacation made especially for his family (The vacation itself has disastrous results for the DeSotos). During a fire at a singles club, Roy becomes dizzy going in to find someone who may have been inside, but was outside with his date. A self-defense instructor is injured by one of his elderly students, a man who developed sudden abdominal pains after proposing to his girlfriend is brought into Rampart, of whom Dixie, Drs. Early and Morton are all taking care. The firefighters rescue two hang glider pilots from the face of a cliff.

Chet and Firefighter Marco Lopez find $80,000 in a transient's mattress after rescuing him from a fire, who later tries to give the firemen a reward. A bride faints while walking down the aisle after suffering from Labyrinthitis, which postpones a honeymoon to Africa. But Dixie proposes they marry in the hospital. Later, Dixie administers a tetanus shot to a young boy. The firefighters help an elderly woman find her lost cat, then assist victims when a plane crashes into a warehouse.

Roy and John complain about the rule that forbids squads from crossing each other's territories. This had delayed their arrival on the scene where a heart patient had almost reached the point of death while the squad assigned to that area dealt with a hypochondriac, after John was speaking to Dr. Brackett about this. Later, they respond to a traffic accident while transporting a non-emergency patient due to the responding Squad being 20 minutes away. An elderly woman demands an "older doctor" to see her; later, when Dr. Brackett visits, while Dixie is around, who asks that she needs to lay back quietly and rest, her daughter has a heart attack. An escaped prisoner gets trapped on a ledge.

Squad 51 is assigned to work the game at the Los Angeles Memorial Coliseum between the USC Trojans and the visiting Stanford Cardinals,, where they deal with a choking victim, a man with breathing difficulties, an injured photographer, and a TV announcer with heart trouble. After John and Roy have not been watching the game enough, Dr. Brackett and Dixie cut them out of Rampart. Meanwhile, a woman accidentally pulls her husband off the roof into a tree.