Middlebury Volunteer Ambulance Association (MVAA) was established in 1970 in the town of Middlebury, Vermont. Before this time, the town's ambulance service was run by a local funeral home, a practice not uncommon for small towns in America during the first half of the twentieth century. The establishment of MVAA and other volunteer EMS organizations in rural areas was made possible through federal funds allocated by the Department of Transportation's 1966 Highway Safety Act. This legislation provided matching funds for every dollar the state of Vermont invested in local volunteer ambulance services. Though federal and state assistance were integral to MVAA's initiation, so too was support from the local communtiy.

During the early years, MVAA's headquarters was located behind the jail on Court Street. It was not until 1980, when the squad nearly doubled its membership from thirty to fifty, that Elm Street became the new operations base.

The evolution of MVAA was also greatly helped by the establishment of first response units thoughout Addison County. These groups continue to make it possible for MVAA to cover ten townships totaling about 400 square miles.