On April 28, 1898, the ambulance service began operations in Moscow. The first carriages were purchased in Paris with funds from merchant Anna Kuznetsova and became known as "Kuznetsova's carriages." They were stationed at the Sushchevsky and Sretensky police precincts, as the police had previously performed the role of emergency assistance. Initially, victims of accidents were taken to police reception rooms for first aid. Now, two specialized ambulance stations opened at the precincts.

However, at first, only authorized individuals, such as police officers, janitors, and watchmen, could call for a carriage, as telephone communication was rare. Therefore, assistance was mainly provided on the street rather than at home. The main patients were intoxicated or injured individuals.

In the first two months, Kuznetsova's carriages were dispatched 82 times. On June 13, 1898, the first disaster occurred where an ambulance was called: a wall under construction collapsed on Jerusalem Passage, injuring 9 people, and both carriages were dispatched to the scene, with five hospitalized.

In 1899, three more ambulance stations opened in Moscow at the Lefortovo, Taganka, and Yakimanka precincts. A year later, a station was added at the Prechisten fire depot, and the seventh began operations in 1902. In 1903, a carriage for transporting pregnant women to the maternity home of the Bahrushin brothers was introduced. Initially, the ambulance service was funded by enthusiasts, and the city began allocating funds only in the early 20th century.

In 1908, medical students founded the Society of Emergency Aid, aiming to remove the stations from police control. However, the authorities did not support this initiative, so in 1912, the society acquired a car and created the Dolgorukovskaya ambulance station, equipped by Dr. Vladimir Pomortsev. In 1913, the car received an award at an exhibition in St. Petersburg and was purchased by the Ministry of Defense.

After the October Revolution, a new stage in the development of ambulance services began. In 1919, the Moscow Council of Workers' Deputies established the city ambulance station, which is now named after Alexander Puchkov, who headed it from 1923 to 1952.

In 1926, a duty point was organized at the Moscow ambulance station for servicing suddenly ill patients at home for the first time. A year later, emergency psychiatric assistance appeared in the capital, and psychiatrists began to be sent to patients.

In 1940, the ambulance station came under the jurisdiction of the Moscow Health Department. In the 1960s, specialized teams emerged in the ambulance service: shock, toxicology, neurology, pediatrics, and for providing assistance in cases of myocardial infarction.