There's no national figure stating from how many attendees you need to hire an ambulance. What remains is a supplementary 1982 regulation and a set of regional rules that don't agree with each other. The same 3,000-person concert requires a first-aid post or ambulance in Alicante, can be covered with a type B ambulance in Bilbao, and has no written figure in Madrid.
When is an ambulance mandatory at an event?
The short answer: in the Valencian Community, from 1,000 people if the event is extraordinary and from 5,000 if it takes place on public roads; in the Basque Country, from 2,000 people when the organiser replaces the first-aid post service; in Catalonia and Galicia the rule talks about a first-aid post, a first-aid kit and medical vehicles, not a specific number of ambulances; in Madrid and Andalusia there's no figure in the regulation, and the licence sets it instead.
This table cross-references the five regional rules that do set out thresholds and the two that leave it to the licence. Each cell reflects what the article says, not a recommendation of ours.
| Region | Rule and article | First-aid kit or first aid | First-aid post or medical staff | Ambulance mandatory by rule |
|---|---|---|---|---|
| Catalonia | Decret 112/2010, Art. 48 | Rest of venues in the catalogue | Music events from 1,000 people of authorised capacity, and special-category venues at any capacity | No: the first-aid post can be replaced with a first-aid kit and medical vehicles |
| Valencian Community | Decreto 143/2015, Arts. 226–228 | Capacity under 1,000; first-aid area between 200 and 1,000 | Capacity of 1,000 or more | Yes: public roads with over 5,000, and extraordinary events with over 1,000 |
| Basque Country | Decreto 17/2019, Arts. 74–78 | Capacity under 700; signposted area and trained person above 300 | From 2,000 expected attendees; plus medical staff above 5,000 | Only if the first-aid post is replaced: one type B ambulance from 2,000 to 5,000, and two above that |
| Galicia | Decreto 226/2022, Art. 12 | Venues under 500 and open spaces under 1,000 | Person with accredited first-aid knowledge between 500 and 1,000 for venues, and between 1,000 and 5,000 outdoors | Not quantified in the decree |
| Madrid | Ley 17/1997 and Decreto 167/2018, Arts. 10 and 12 | Supplementary national regulation applies | Not quantified | Not quantified: availability of required ambulances must be evidenced from 501 people |
| Andalusia | Decreto 195/2007, Art. 9 | Supplementary national regulation applies | Not quantified | Not quantified: covered by the emergency plan and the resolution |
Two takeaways from that table, which are ours, not the regulations'. First: of the six rules compared, only one — the Valencian one — turns the ambulance into a direct obligation based on capacity; the rest treat it as an alternative to the first-aid post or leave it to the licence. Second: the gap between the strictest region and the one that sets no figure falls in the 1,000-to-5,000-attendee range, which is exactly where most venue concerts and local festivals sit.
What does the national rule say: Article 11 of the 1982 regulation?
The national baseline comes from a regulation that's forty-four years old. Article 11 of Real Decreto 2816/1982, General Regulation on Public Entertainment and Recreational Activities Policing states: «Siempre que el aforo del local exceda de 1.000 o de 100 espectadores o asistentes, se dispondrá respectivamente, de una enfermería o botiquín convenientemente dotados para prestar los primeros auxilios en caso de accidente o enfermedad repentina» ("Whenever the venue's capacity exceeds 1,000 or 100 spectators or attendees, a suitably equipped first-aid post or first-aid kit, respectively, shall be provided to give first aid in the event of an accident or sudden illness"). The same article allows the first-aid post to be replaced with a first-aid kit and the presence of ambulances.
That part is still in force. The Technical Building Code repealed its Articles 2 to 9 and 20 to 23, and Real Decreto 393/2007 removed Articles 24 and 25, but Article 11 isn't among those repealed. It applies on a supplementary basis: it governs wherever the autonomous region hasn't written its own rule. The Community of Madrid itself classifies it on its public entertainment website as «normativa con carácter supletorio» ("supplementary regulation").
It's worth noting what Article 11 doesn't say. It sets no per-attendee ratios, doesn't mention ambulance type, doesn't require a defibrillator — that concept didn't exist in 1982 — and doesn't distinguish between an indoor venue and an outdoor site. The regions have since filled in all of that, with different criteria and at different times.
What does each autonomous region require?
Four regions have written specific thresholds. The differences aren't a matter of nuance: they change the medical-cover budget and the time the doors can open.
Valencian Community: the only one that mandates an ambulance by capacity
Decreto 143/2015, which approves the Regulation implementing Ley 14/2010, devotes three articles to medical equipment. Article 226 requires a portable first-aid kit for all events with a capacity under a thousand people and adds, between 200 and 1,000, «un lugar destinado a los primeros auxilios y otras posibles atenciones sanitarias» ("an area for first aid and other possible medical care"). Article 227 raises the bar from a thousand upwards: «dispondrán de un servicio de enfermería, con la dotación mínima exigida por la legislación vigente o, en su defecto, de un botiquín y una ambulancia» ("they shall have a first-aid post, with the minimum staffing required by the legislation in force, or failing that, a first-aid kit and an ambulance").
Article 228 is the one that answers the title question. It requires «al menos, una unidad de evacuación o ambulancia, debidamente equipada» ("at least one duly equipped evacuation unit or ambulance") in three cases: events that «requieran de la utilización de vías públicas y concentren un aforo superior a 5.000 personas» ("require the use of public roads and gather a capacity of over 5,000 people"); extraordinary, singular or exceptional events «con aforo superior a 1.000 personas» ("with a capacity of over 1,000 people"); and those that, because of their risk, are required to by a reasoned resolution of the competent authority. Paragraph 2 adds the timing and the consequence: available «desde una hora antes del comienzo» ("from one hour before the start") until closing, and «la ausencia, siquiera momentánea, de la ambulancia producirá la suspensión del espectáculo o actividad» ("the absence of the ambulance, even momentarily, shall result in the suspension of the event or activity").
Basque Country: ambulance types and a deadline for replacement
Decreto 17/2019, the regulation implementing Ley 10/2015 on public entertainment, is the most detailed of those reviewed. Its Article 74 requires a basic first-aid kit below 700 people and, above 300 when there's no first-aid post, a signposted first-aid area and «una persona con conocimientos acreditados de primeros auxilios» ("a person with accredited first-aid knowledge"). Article 75 requires a defibrillator above 700.
Article 76 sets the first-aid post requirement «en los espectáculos públicos o actividades recreativas que congreguen previsiblemente a 2.000 personas o más» ("for public events or recreational activities expected to gather 2,000 people or more"), with at least one qualified nurse, adding a qualified doctor if expected capacity exceeds 5,000. Article 77 allows that service to be swapped for a first-aid kit and ambulances: one type B ambulance between 2,000 and 5,000 people, and two above 5,000, «una de tipo B y otra de tipo C con una persona titulada en medicina» ("one type B and one type C with a qualified doctor"). If the ambulance evacuates someone, the unit must be replaced: «En caso de no disponer del recurso mencionado o si en el plazo de media hora la dotación no ha sido repuesta, se suspenderá el espectáculo o actividad y se procederá al desalojo del local» ("If the above resource is unavailable, or if it hasn't been replaced within half an hour, the event or activity shall be suspended and the venue evacuated"). Above 10,000 people, Article 78 allows the licence to impose extraordinary provisions following a study submitted by the applicant.
Catalonia: first-aid post from 1,000, and the licence above that
Article 48 of Decret 112/2010, the Catalan Regulation on Public Entertainment and Recreational Activities, requires a first-aid post for music venues and musical recreational activities «a partir de 1.000 persones d'aforament autoritzat» ("from 1,000 people of authorised capacity") and for special-category venues at any capacity. It allows this to be replaced «per una farmaciola i la presència de vehicles medicalitzats» ("with a first-aid kit and the presence of medical vehicles") while the venue is open, and closes with the line that actually decides the real set-up: «La llicència o autorització pot establir la necessitat de dotacions mínimes específiques» ("The licence or authorisation may establish the need for specific minimum provisions"). The rest of the catalogue, below that capacity, stays at first-aid-kit level. The Generalitat's procedures website summarises the same requirement for anyone applying for a licence.
The Catalan medical set-up isn't negotiated on its own. Article 42 requires a *memòria de seguretat* (safety report) for musical recreational activities with an authorised capacity above 150 people and for special-category venues, and its content must «determinar els dispositius d'assistència sanitària de l'establiment» ("determine the venue's medical cover provisions"). In other words: the figure comes from the document accompanying the licence, not from the regulation itself.
Galicia: tiers by type of space, with no ambulance requirement in writing
Decreto 226/2022, in force since February 2023, separates venues from open spaces. Its Article 12.1 requires a signposted first-aid kit for venues with a capacity under 500 people and for open spaces with a capacity under 1,000, with a set contents list: disinfectants, sterile gauze, hydrophilic cotton, bandages, adhesive tape, dressings, scissors, tweezers and disposable gloves. Article 12.2 adds, for venues of 500 to 1,000 and open spaces of 1,000 to 5,000, a signposted first-aid area and «una persona con conocimientos acreditados en asistencia sanitaria inmediata» ("a person with accredited knowledge in immediate medical assistance").
Above those tiers, the Galician decree doesn't specify a first-aid post or an ambulance: Article 12.3 refers to the self-protection regulations. A 20,000-person festival in Galicia has its medical set-up defined in the self-protection plan and the authorisation, not in the entertainment regulation.
What if you're organising in Madrid or Andalusia, where there's no figure?
Then the figure comes from the file itself. The Ley 17/1997 on Public Entertainment of the Community of Madrid contains no article on ambulances, first-aid posts or first-aid kits: its Article 6.2 speaks generically of «seguridad para el público asistente, trabajadores, ejecutantes y bienes» ("safety for the attending public, workers, performers and property"), and 6.3 requires insurance. The medical side appears in the application process, not in a fixed requirement.
Decreto 167/2018, regulating extraordinary recreational activities and extraordinary events, confirms this. For extraordinary recreational activities with a capacity of 501 people or more, its Article 10 requires, among the documentation, a «documento acreditativo, en su caso, de la disponibilidad de las ambulancias» ("document evidencing, where applicable, the availability of ambulances"), together with the «medidas de seguridad y vigilancia, así como sanitarias de prevención que se pretenden adoptar» ("security, surveillance and preventive medical measures to be adopted"). For extraordinary events, Article 12 requires a «documento acreditativo de la disponibilidad de las ambulancias exigibles» ("document evidencing the availability of the required ambulances"). The Madrid regulation doesn't say how many are required: it says they must be evidenced.
Something similar happens in Andalusia. Decreto 195/2007, on general conditions for occasional and extraordinary public events, is a procedural rule: its Article 9.1.b) requires an «plan de emergencia y autoprotección, para asegurar, con los medios humanos y materiales de que dispongan, la prevención de siniestros y la intervención inmediata» ("emergency and self-protection plan, to ensure, with the human and material resources available, the prevention of incidents and immediate intervention"), and for sporting events, a technical federation report assessing the «suficiencia e idoneidad de los medios de seguridad, asistencia médica, evacuación y extinción de incendios» ("sufficiency and suitability of security, medical assistance, evacuation and fire-extinguishing resources"). No ratios, no capacities. Anyone organising in these two regions can't budget the medical set-up by reading the regulation: they have to ask the town council and the regional body before closing the budget, as is already the case with licences and permits for events in Madrid, Barcelona and Valencia.
What counts as a mass gathering event?
There's no single legal definition in Spain, and that's the honest answer. The closest thing to a common criterion is the threshold that triggers the self-protection plan, and even that isn't the same everywhere.
| Framework | Threshold that triggers the self-protection plan |
|---|---|
| National: Real Decreto 393/2007, Annex I, section 1.d) | Enclosed buildings from 2,000 people; enclosed demountable or seasonal facilities from 2,500; outdoors, «en general, aquellas con una capacidad o aforo igual o superior a 20.000 personas» ("in general, those with a capacity of 20,000 people or more") |
| Catalonia: Decret 112/2010, Art. 46 | Venues from 2,000; outdoors in unenclosed spaces above 15,000; outdoors in enclosed spaces above 5,000; lower tier from 500 |
| Basque Country: self-protection catalogue amended by Decreto 17/2019 | Enclosed buildings above 300 people; enclosed venues above 700; open spaces from 10,000 |
Real Decreto 393/2007, the Basic Self-Protection Standard, sets those thresholds as a minimum or supplementary baseline, not a ceiling: regions and town councils can lower them, and they do. Between the national outdoor threshold — 20,000 people — and the Catalan one — 1,000 expected attendees for the lower tier — there's an order of magnitude for the same festival. If your question is whether your event "counts as a mass gathering", the more useful question is different: which threshold applies in your region, and which document the licence requires. We break down the rest of the safety file in the events security guide.
What happens if the ambulance leaves with an injured person?
The event stops, wherever the rule says so in writing. It's the operational detail most often overlooked when hiring the service, because it affects the continuity of the event, not just the paperwork.
The Valencian Community says it twice. Article 227 warns that «la ausencia, siquiera momentánea de la ambulancia, supondrá la suspensión del espectáculo o actividad» ("the absence of the ambulance, even momentarily, shall result in the suspension of the event or activity"), and Article 228.2 repeats the formula for the cases where the ambulance is mandatory. The Basque Country sets a clock: Article 77.d) of Decreto 17/2019 requires the unit to be replaced immediately and, in the meantime, requires «una persona con conocimientos en primeros auxilios» ("a person with first-aid knowledge") to be available; if it hasn't been replaced within half an hour, «se suspenderá el espectáculo o actividad y se procederá al desalojo del local» ("the event or activity shall be suspended and the venue evacuated").
The practical consequence is contractual. A single-ambulance set-up at a venue with no backup turns any hospital transfer into a stoppage of the event. When the spec allows a choice, two units or a replacement agreement with the medical transport company cost less than a suspension halfway through the line-up, and that decision gets made beforehand, not at the first-aid post.
What does a bullfighting event or a sporting event require?
Here there is a national rule with actual figures. Bullfighting events are governed by Real Decreto 1649/1997, regulating the medical facilities and surgical-medical services at bullfighting events. Its Annex I requires at least one duly equipped evacuation unit — a mobile ICU-type ambulance or similar — available from one hour before the start and throughout the event, positioned as close as possible to the first-aid post and at the disposal of the head of the medical service. It also details the minimum make-up of the surgical-medical team for bullfights, novilladas with picadors, rejoneo and festivals: head of service who is a surgeon or trauma specialist, first and second assistants, anaesthetist-resuscitator, nursing staff and auxiliaries.
The general bullfighting framework sits in Article 24 of the Bullfighting Events Regulation, which requires organisers to guarantee medical assistance and refers to specific rules for the minimum requirements. In other words: an event involving bulls has written into the BOE what a music festival doesn't.
For sporting events that take place on public roads, the route is the regional regulation plus traffic authorisation. In the Valencian Community, Article 228.1.a) of Decreto 143/2015 makes the ambulance mandatory when the event «requiera de la utilización de vías públicas» ("requires the use of public roads") and gathers a capacity of over 5,000 people. In Andalusia, the federation report under Decreto 195/2007 must assess the suitability of medical assistance. If your event is a race or a march, the medical set-up gets negotiated in the same file as the road closures, not afterwards.
And what part of this does Futura Tickets cover?
None of the medical side: the organiser contracts the set-up directly with a medical transport company, and the competent authority approves it. What a ticketing platform contributes to that file is the data almost every rule assumes and none actually solves: how many people are inside at any given moment, and in which zone. Futura Tickets is a Spanish SaaS ticketing platform for professional event organisers. In its operational guide, Futura Tickets recommends setting capacity alerts at 80% and 95% of each zone's capacity, which is the warning that allows access to be closed before the first-aid post becomes overwhelmed. The Futura Tickets app validates a QR code in 1-2 seconds and an NFC wristband in under 1 second, and Futura Tickets charges no monthly fee: €0 a month, just a commission per ticket sold. Pricing details are at pricing, and the operational detail of headcounting is in the real-time capacity management guide.
What to check before signing off on the medical set-up
Six checks. None of them depend on any rule changing.
Identify your administrative category, not just your capacity. «Extraordinary», «singular», «occasional» and «on public roads» aren't just adjectives: they're categories that trigger different obligations. In the Valencian Community, being classed as extraordinary lowers the ambulance threshold from 5,000 to 1,000 people.
Read your region's article before requesting a quote. Medical transport companies quote for what you ask them for. If you ask for "an ambulance" where the rule requires a first-aid post with qualified staff, the gap will show up at inspection, not on the invoice.
Ask in writing what the licence requires. In Catalonia, Madrid and Andalusia, the figure comes from the authorisation. An email to the town council with the expected capacity and the type of activity is worth more than any table, including the one in this article.
Fix the cover hours in the contract. From one hour before doors open until final closing is what the Valencian and Basque rules require. If your contract starts with the first act, you have a documented gap.
Agree replacement terms after a transfer. What happens when the ambulance leaves the venue, how long the replacement takes to arrive, and who notifies production. In the Basque Country that deadline is set at half an hour.
Cross-check the medical set-up against the self-protection plan and your actual capacity. The plan is signed off by a qualified technician and your access control counts the actual capacity; medical staffing is sized against the forecast. If you sell more tickets than you declared, you have two problems, and only one of them is medical. The promoter's obligations, with comparative insurance scales, are covered in the festival security analysis, and the earlier steps on licensing and capacity are in the guide to organising a festival in Spain.
None of this turns a promoter into a medical expert, and it shouldn't. It turns them into someone who knows which article applies to them, what they need to evidence, and at what point their event could be stopped. With six different regulations on the table, that's already an advantage.
Sources
- Real Decreto 2816/1982, General Regulation on Public Entertainment and Recreational Activities Policing: Article 11 (consolidated text, BOE)
- Real Decreto 393/2007, Basic Self-Protection Standard: Annex I, section 1.d) (consolidated text, BOE)
- Ley 17/1997, of 4 July, on Public Entertainment and Recreational Activities of the Community of Madrid: Article 6 (consolidated text, BOE)
- Real Decreto 1649/1997, medical facilities and surgical-medical services at bullfighting events (consolidated text, BOE)
- Decret 112/2010, Catalan Regulation on Public Entertainment and Recreational Activities: Articles 42, 46 and 48 (Portal Jurídic de Catalunya)
- Canal Empresa (Generalitat de Catalunya): requirements and obligations for public entertainment and recreational activities
- Decreto 143/2015, Regulation implementing Ley 14/2010 on Public Entertainment of the Valencian Community: Articles 226–228 (DOGV no. 7615, 15-09-2015, PDF)
- Decreto 17/2019, Regulation implementing Ley 10/2015 on Public Entertainment of the Basque Country: Articles 74–78 (BOPV no. 37, 21-02-2019, PDF)
- Decreto 226/2022, organisation and conduct of public entertainment and recreational activities in Galicia: Article 12 (DOG no. 13, 19-01-2023)
- Decreto 167/2018, extraordinary recreational activities and extraordinary events of the Community of Madrid: Articles 10 and 12 (BOCM no. 297, 13-12-2018, PDF)
- Decreto 195/2007, general conditions for occasional and extraordinary public entertainment and recreational activities in Andalusia: Article 9 (BOJA no. 137)
- Community of Madrid: regulations on public entertainment and recreational activities, with Real Decreto 2816/1982 as the supplementary rule