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Terrorism, unfortunately, continues to be perpetrated against innocent civilians throughout the world. This activity ranges from stabbings, shootings, bombings, or car-rammings by the lone terrorist, to large-scale destructive acts such as that of the Twin Towers on September 11, 2001. One must also prepare for chemical, biological, radiological, or nuclear terrorism (CBRN). A combination of extreme fundamentalist ideologies and social networking has accentuated terrorism in many parts of the world. To achieve their nefarious goals of inflicting as many casualties on civilians as possible, the terrorists choose to target places with high civilian concentration. Hence, they disproportionately attack urban areas such as buses, trains, shopping malls, and restaurants. Emergency Medical Services (EMS) must prepare themselves to deal with some of the unique challenges of terrorist attacks.