The O'Neill Rural Fire Department is housed in the City Fire Hall, built in 1973. The Rural Department has the following: One 6 x 6 1000 gallon tanker, three 4x4 grass rigs, each with 300 gallon tanks and 18 horse pump motors, a 1996 Luvern Commercial Pumper that is a four door Freightliner with a 1250 GPM pump, 1000 gallon water, jaws of life, 5000 watt generator, and miscellaneous tools, 1992 IH Luvern 6 wheel drive tanker with 2200 gallon of water, a 2003 International 4 wheel drive, Crimson Fire pumper with a 1250 GPM pump and 1200 gallon water, a 1972 Ford F600 with 1200 gallon water and a 300 QPM pump, and a 1982 Ford tanker with 100 gallon water. All rural trucks have pump and toll capabilities.

The O'Neill City Fire Department has a 2002 Crimson Fire F 550 4x4 rescue truck with a 5000 watt generator, jaws of life, 30 gallon foam tank, 300 gallon water, command light system, 300 GPM pump, and many miscellaneous small tools and equipment. The city of O'Neill frontline pumper is a 1992 Ford Luvern Commercial 1250 GPM pumper with 500 gallon of water, 2000 feet of 5 inch LDH. This truck is equipped with a six man command cab with four SCBA built-in seat. The last city truck is a 1972 aerial with a 1000 GPM pump, 66 foot ladder built by Smeal and recertified in 2004.

The ambulance department is owned in a partnership by rural and city. They have three ambulances, a 2002 Ford E450 Modular, a 2001 E350 Modular, and a 1995 E350 Modular.