Introduction Paramedicine has undergone significant change in the past two decades. While the Anglo-American paramedic system continues to grow there appears to be a dearth of published literature regarding modern categorisation of this evolving paramedic system. The objective of this scoping review is to examine and map the existing evidence to provide an overview of the characteristics and structural similarities and differences of Anglo-American paramedic systems in English-speaking developed countries. Methods Databases, including Embase, MEDLINE, Web of Science, EBSCOhost, CINAHL, Google Scholar and Epistemonikos, will be searched from inception. A grey literature search strategy has also been developed to identify non-indexed relevant literature. Citations and references of included studies will also be searched. Two reviewers will undertake title and abstract screening, followed by full text screening. Data extraction will be conducted using a customised instrument. Inclusion criteria: results examining management, leadership or governance in paramedicine related to the Anglo-American paramedic model in English-speaking developed countries will be included in the review. Included studies will be summarised using narrative synthesis structured around themes of management, leadership and governance in paramedicine.