The conventional emergency medical rescue vehicle communication system mainly uses the Modbus serial communication protocol to generate the emergency communication center, which is vulnerable to the effect of communication network connection, resulting in high communication delay. Therefore, a new low delay communication system for emergency medical rescue vehicles needs to be designed based on the narrowband Internet of Things. In the hardware part, ASIP rescue image processor and FPGA multi-channel high-definition communication camera are designed. In the software part, the communication model of the emergency medical rescue vehicle is constructed, and the rescue communication function module is designed based on the narrowband Internet of Things, thus realizing the low delay communication of the emergency medical rescue vehicle. The system test results show that the communication delay of the designed low delay communication system of emergency medical rescue vehicle based on narrowband Internet of Things is low, which proves that the designed low delay communication system of emergency medical rescue vehicle has good communication performance, reliability and certain application value, and has made certain contributions to reducing the risk of emergency medical rescue.