Emergency responders are frequently exposed to life-threatening risks when attending to critical incident events causing an increasing number of psychological health issues among emergency responders. However, few studies are related to workload and its association with Malaysian emergency responders' mental health problems. Hence, the study objective is to identify the level of workload, determine the level of psychological well-being and their association with Malaysian firefighters. A cross-sectional study was conducted among Grade A and B stations firefighters in Kota Bharu Kelantan using a validated NASA-TLX and DASS-21 questionnaire through a purposive sampling method. Respondents were divided into standard operations teams and elite teams such as Emergency Medical Rescue Services (EMRS). Results show that although EMRS, the medical team has the highest overall workload demand, firefighters deemed performance and effort demand a significant workload demand comparing to others. It is also found that most firefighters have higher anxiety issues comparing to depression and stress, where 30% to 61% of respondents develop a certain level of anxiety corresponding to only 15% to 39% for depression and 13% to 28% for stress. Hence, it is suggested that further research should be conducted in investigating and understanding the contributing factors towards Malaysian firefighters’ psychological health problems so that they can be managed or even prevented.