This study aims to quantitatively and qualitatively evaluate the operational effects of an emergency-vehicle preemption (EVP) system implemented in Anyang City and to derive improvement directions based on both empirical performance outcomes and user-experienced insights. Specifically, this study integrates three complementary methodologies: (1) controlled field tests comparing pre- and post-EVP travel performance under consistent traffic and signal conditions, (2) a one-year operational evaluation using 204 actual dispatch cases collected from six 119 Safety Centers, and (3) a structured survey of frontline firefighters who directly utilized the EVP system during actual emergency responses. The field test results indicated that the average travel time reduced by approximately 44% while the average travel speed increased by approximately 79%, with paired t-test verification confirming that the observed improvements were statistically significant and attributable to the EVP system instead of to random variations. Similarly, the operational evaluation indicated that the actual travel time reduced by an average of 49% compared with navigation-estimated values, whereas the golden-time (5 min) arrival rates for both fire/rescue and medical dispatches exceeded the regional average, with consistent performance demonstrated even under varying travel distances and road complexities. The firefighter survey further reinforced these findings, with respondents reporting clear improvements in golden-time achievement, reduced anxiety toward potential safety risks, and enhanced perceived safety during emergency trials, as well as identified several practical limitations such as route mismatches, occasional system malfunctions, and difficulty in perceiving preemption activation—factors that suggest necessary technical and operational refinements. In general, the EVP system was evaluated as an effective and highly practical tool that improves emergency-vehicle mobility, arrival-time stability, and operational reliability across diverse dispatch conditions. The combined quantitative and qualitative verification in this study underscores its value as a field-proven technology. Future studies should expand to multiregional longitudinal datasets, controlled analyses considering external variables such as traffic volume and weather, and quantitative evaluation of safety-related impacts such as reductions in intersection collisions or on-route risk exposure to assess the system’s broader policy and operational benefits more comprehensively.