Background: Ambulance response time (ART) plays a significant role in patient survival, especially in cardiac emergencies; qualifying as the crucial factor to measure the quality of prehospital emergency care. Thus, this retrospective, cross-sectional study aimed to measure the ART to public cardiac emergencies and to analyze its association with patient survival in Riyadh. Methods: Records of cardiac emergency medical services from the Saudi Red Crescent Authority for 1 year (January 1, 2013–December 31, 2013) in Riyadh were requisitioned. ART was calculated for 18 stations across Riyadh and assessed for confounding factors such as time (day of the week and time of the day), age, gender, and location of the incident. Results: The mean ART was approximately 13 min, with a trend toward prolongation during working hours on weekdays. ART and survival were unaffected by gender and location of the incident but was confounded by the age of the patient (P = 0.001). Conclusions/Recommendations: ART was much longer than the defined international standard of 8 min and comparable to other regions of the world. We recommend the use of motorcycles to transport paramedics to the emergency site, air ambulance, and dedicated ambulance lanes to reduce ART.