Emergency medicine is a medical specialty—a field of practice based on the knowledge and skills required to prevent, diagnose, and manage acute and urgent aspects of illness and injury affecting patients of all age groups with a full spectrum of undifferentiated physical and behavioural disorders. It further encompasses an understanding of the development of pre-hospital and in-hospital emergency medical systems and the skills necessary for this development The future of the emergency medicine will be characterized by continuous advances in practices, research, technologies, and so forth. In terms of clinical practices, problems such as inefficiency and crowding may arise and cause tension in emergency departments. The development of emergency medicine is still in its primary stage and is extremely uneven between rural and urban areas. The resolution of such issues and optimization of processes in emergency medicine can be realized by implementing an increasing number of equipment configurations, improving the structure of emergency medical personnel, and establishing a closer linkage between out-of-hospital and in-hospital emergency services. In essence, “process optimization and early treatment” manifests as an influential component in the development of emergency medicine. In the optimization of the emergency process, the stability of emergency medical professionals is a valuable resource. In this original paper inspiring in the true story of emergency medical service as provided in tertiary care medical college hospital we the academic emergency medicine team tried to have a glimpse of past present and future of EM, through upgrading clinical emergency care competence, including rapid response, effectiveness, and service attitude, and improving the skills of medical professionals in the emergency department are of great importance.