Background <p>This study examines the relationship between rumination and job Fatigue among pre-hospital emergency personnel in Ardabil Province, as well as the role of demographic and occupational factors in shaping these outcomes.</p> Methods <p>This cross-sectional descriptive study included 338 pre-hospital emergency personnel from Ardabil Province, selected through census sampling. Data were collected using the Nolen-Hoeksema and Morrow Rumination Questionnaire, which measures general rumination, and the Swedish Job Fatigue Inventory to assess Job fatigue. Descriptive statistics, t-tests, and ANOVA were performed using SPSS software.</p> Results <p>The mean total score for job fatigue was 93.14 ± 10.32, while the mean score for rumination was 53.12 ± 10.34, both indicating moderate levels. Significant correlations were found between job fatigue and demographic or occupational factors such as age (<i>p</i> = 0.02), work experience (<i>p</i> &lt; 0.001), workplace (<i>p</i> &lt; 0.001), and shift type (<i>p</i> &lt; 0.001). Regarding rumination, significant associations were also observed with age (<i>p</i> = 0.03), work experience (<i>p</i> &lt; 0.001), and workplace (<i>p</i> &lt; 0.001). Additionally, shift type showed a significant relationship with rumination (<i>p</i> &lt; 0.001).</p> Conclusions <p>Demographic and job-related factors, including age, work experience, workplace, and shift type, significantly affect the levels of rumination and job fatigue in pre-hospital emergency personnel. Implementing targeted support programs and optimizing shift management may help reduce psychological strain in this workforce.</p> Clinical trial number <p>Not applicable.</p>