Nearly 2000 paramedics will join NSW's "worked to the bone" workforce as the state government commits to a funding boost.
The Health Services Union has welcomed the announcement following several industrial actions by NSW paramedics this year.
Secretary Gerard Hayes dubbed it a historic win for paramedics who had been "consistently under-resourced".
"For too long, paramedics have worked themselves to the bone to protect the community," he said.
"This announcement will allow them to deliver even better care to the community while also protecting their own health and wellbeing."
The NSW government will move to fund 1858 new paramedics and 30 more ambulance stations across the state in the coming budget.
It will cost the budget $1.76 billion over four years, including cash for 210 ambulance support staff, 52 nurses and eight doctors.
But Mr Hayes said paramedics still needed a wages boost to help paramedics keep up with the cost of living.
It comes the same day Unions NSW warned public sector workers could be out thousands of dollars under the current 2.5 per cent wage rise cap and growing inflation rates.
Paramedics would see a more than $5000 cut to their take home pay over the next three years if their wages don't rise to keep up with the cost of living.
Premier Dominic Perrottet called Sunday's announcement a "generational investment" and flagged a "fair and reasonable" wages announcement closer to state budget day on June 21.
"We will make an announcement in relation to wages as we work through the budget," he said.
"We understand the concerns of rising inflation across the country.
"Wages is one aspect ... but investing in staff is also crucially important, so we'll balance those competing interests.
The report from Griffith University Business School's Professor David Peetz also warns firefighters, police, nurses and teachers would lose between $5000 to $6500 over the same period if wages aren't boosted.
Mr Hayes said paramedics' wages didn't reflect the reality of their work.
"Without a serious pay rise it will be hard to recruit and retain the extra paramedics announced today. We will continue to press for fair pay," he said.