Objective: Over the past decade, the German tele-emergency medical system (tele-EMS) has undergone continuous expansion. This growth has introduced a range of innovations that have transformed the daily work of tele-EMS physicians. At the same time, it has also brought new challenges, including parallel rescue operations, supra-regional deployments, and an increasing number of patient cases. To address these issues, the utilisation of an artificial intelligence (AI) system developed specifically for tele-EMS physicians was investigated. Methods: As part of a qualitative study, 11 tele-EMS physicians were interviewed to understand their perspective on the implementation of AI in the field of tele-emergency medicine. The interview questionnaire covers a range of topics, including requirements and concerns of tele-EMS physicians regarding the use of the specific AI system, as well as their willingness to work with this system in future. Results: The results of the study reveal that, despite certain concerns and fears, tele-EMS physicians are generally positive about the implementation of AI technology in prehospital tele-emergency medicine. When designed effectively, the system is considered potentially suitable for reducing the workload of tele-EMS physicians and improving the quality of patient care. Conclusions: This study addresses a significant gap in the field of telemedicine research by examining perceptions of tele-EMS physicians regarding the implementation of AI in prehospital tele-emergency medicine, while also outlining critical ethical considerations related to AI integration in tele-emergency care. Furthermore, it provides a set of items for a qualitative interview study that can be easily adapted for use with other medical technologies.