The Anchorage Fire Department runs 14 Engine Companies when fully staffed. Engines are smaller then Ladder Trucks and are primarily used for fire attack, water supply, and respond to emergency medical incidents.

A majority of the Engines are staffed with at least one Paramedic. By having Paramedics on Engines, the AFD has the ability to provide a higher level of Advanced Life Support care to the community then you would find in cities where fire departments do not provide Emergency Medical Services. Having medically trained personnel on the Engines is a major reason that Anchorage has a higher cardiac arrest survival rate (38%) than many other places, well above the national average of 7%.

In parts of Anchorage that are served by a Fire Station without an ambulance, an Engine will usually arrive to an emergency medical scene and provide critical life saving intervention, which can be as complicated as giving CPR and early defibrillation in the event of a cardiac arrest, or as simple as bandaging traumatic wounds. This stabilization allows the Anchorage Fire Department to concentrate ambulances in other parts of the city that see higher medical response frequency.