The Pleasant Hill Rural Fire Department was established in March 1976. They initially used a skid truck with a tank donated by the S.C. Forestry Commission and later acquired a 1953 Ford F-750 truck from Johnsonville Fire Department. The original members included Tom E. Owens, Lenny Owens, Ervin O. Poston, Hugh W. Snowden, Wayne M. Owens, W. Wendell Cribb, Waylon Owens, and A. E. Barnhill Jr.

In 1982, the Georgetown County Fire Department was formed by merging several volunteer departments, and they purchased six pumpers and one tanker. These were initially stationed at District Chiefs' homes until stations were built in 1985. The first Fire Chief was Gene Armstrong, succeeded by Mack Reed Jr. in 1989. Additional stations and pumpers were added in subsequent years.

In October 2002, the department replaced the apparatus stationed at Sandy Island. In July 2005, the department merged with Georgetown County EMS to create Georgetown County Emergency Services. EMS operates from six locations and responds to approximately 5,000 calls per year.

In 2008, the department added two 1000-gallon pumpers and two 2000-gallon tankers. Currently, Georgetown County Fire/EMS is staffed with career personnel working in three 24-hour shifts.