Night vision goggles (NVGs) are used by military personnel operating in low-light environments. It is not known whether NVGs can be used by medical personnel to provide emergency care under such conditions. This was a randomized controlled study to determine the effect of NVGs on the performance of intravenous line insertion (IVI) and endotracheal intubation (El) on training manikins. Emergency physicians and paramedics were randomized to perform EI and IVI in ambient light or in total darkness using NVGs. Each skill was repeated three times, and averages were determined. The average times for EI in ambient light and with NVGs were 48.4 and 188.2 seconds, respectively (SE of 13.4 seconds for both; p < 0.0001). The average times for IVI in ambient light and with NVGs were 34.7 and 73.7 seconds, respectively (SE of 4.1 seconds for both; p < 0.0001). Emergency personnel were able to successfully perform these skills using NVGs, but their times were significantly longer than in ambient light.