The NSW Australian Paramedics Association (APA) is striking for 12 hours on Friday despite the threat of legal action.
From 7am to 7pm, members will only attend “lights and sirens” calls as pay disputes remain ongoing.
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On Thursday, the Industrial Relations said any strike action by the state’s smaller paramedic unions wouldn’t be protected and face fines of up to $20,000 per day.
The Health Services Union has also condemned the strike.
Paramedics are fighting for equitable pay, improved working conditions and a resolution to the NSW healthcare crisis.
APA president Brett Simpson said the strike “symbolises our unyielding quest for justice”.
“This fight is about our paramedics’ welfare and the quality of healthcare for everyone in NSW,” he said.
“As the lowest paid in the country, our paramedics not only suffer financially but also experience a draining of skilled professionals to other states.
“This isn’t just about us. It’s about the well-being of the entire NSW community. Paramedics are the linchpin for the safety and security of every person in NSW. We urge public support to safeguard healthcare quality.”