Background: As worldwide life expectancy increases, the Swedish Ambulance Service is likely to be affectedby the demographic shift towards a larger proportion of older persons. An older population tends to in-crease the demand for ambulances, indicating a need to illuminate older patients’ perspective. Thus, the aimof this study was to explore older patients’ perceptions of the Swedish Ambulance Service. Methods: This interview study employed a descriptive qualitative design with a phenomenographic ap-proach in accordance with Dahlgren and Fallsberg. Results: Three main descriptive categories emerged to describe the underlying conceptions in the inter-views; A double-edged encounter, Trust is created by perceived competence, and Safety through accessibility invulnerable situations. Conclusion: Older patients described trust in ambulance clinicians as a prerequisite for feeling safe enoughto share their feelings and allow a bodily examination. However, they also criticized the care providedbecause they questioned the need for certain actions.