The Division of Operations is responsible for the day-to-day delivery of critical emergency medical services (EMS), fire suppression, hazardous materials, and technical rescue mitigation to the residents and visitors of Montgomery County. The division is organized into four primary sections:

Field Operations: the nearly 1,200 career employees who provide fire, emergency medical, and rescue services across Montgomery County.

Communications Section: career firefighters assigned to the ECC, responsible for dispatching the proper response assignment, ensuring fire-rescue response personnel have adequate situational awareness of the dispatched event, and managing all response communications and technologies.

Special Operations: provides specialized training, planning, technical support, and response in the areas of hazardous materials, technical rescue, water-ice rescue, passenger rail support, bomb/explosive incidents, fire and explosives investigations, and interoperable communications resources.

Emergency Medical and Integrated Healthcare Services (EMIHS): provides guidance and oversight for all pre-hospital care services provided by MCFRS.

MCFRS Operations' personnel operate from 37 Fire and Rescue stations. The career and volunteer components of this combination department work in an "Integrated Emergency Command Structure" that defines the authority and responsibility for all members of the service. MCFRS responds to more than 130,000 emergency incidents annually. Requests for emergency medical assistance comprise the majority of those incidents; in FY24, there were nearly 114,000 dispatched EMS calls and approximately 27,000 fire incidents, technical rescue, and hazardous materials incidents combined.