Background: The prevalence of the Coronavirus disease 2019 (COVID-19) pandemic, as one of the biggest global health threats, has had psychological impacts on healthcare workers (HCWs) and all aspects of their mental health, particularly resilience. Objectives: This study aimed to investigate the relationship between mental health and resilience in prehospital emergency medical services (EMS) practitioners. Methods: This descriptive/analytical cross-sectional study was conducted in 2020 using a web-based questionnaire, wherein the data were collected from a total number of 115 EMS practitioners working in 115 EMS stations in Golestan province, northern Iran, selected using convenience sampling. The data collection tools were also the General Health Questionnaire-28 (score range: 0 - 84) and the Connor-Davidson Resilience Scale (score range: 0 - 100). The relationship between both questionnaires was then examined by structural equation modeling via maximum likelihood estimation. In addition, multiple linear regression (MLR) was applied to reflect on the factors affecting the resilience mean score. Results: The mental health and resilience mean scores in the EMS practitioners were 25.73 ± 8.90 and 72.25 ± 12.63, respectively. Furthermore, 43.5% and 49.6% of the subjects had good and mild mental health conditions, respectively. The correlation coefficient between both questionnaires (-0.51) revealed that mental health deterioration diminished resilience in the EMS practitioners. Additionally, the type of employment and mental health mean score had a significant effect on the resilience mean value (R2 in MLR = 0.54). Conclusions: The study results demonstrated that more than half of the EMS practitioners had moderate mental health status, and their resilience mean score was high. Therefore, it is suggested to evaluate the prevalence of other common types of mental problems, such as anxiety, depression, and sleep disorders, in HCWs during the COVID-19 pandemic at the national level in future studies. [ABSTRACT FROM AUTHOR]