Rates of non-conveyance (referred to as a patient refusal or non-transport in areas outside of Australia), defined as paramedic discharge of a patient in the community rather than transporting them to hospital, are increasing. These episodes of care require complex decision-making from paramedics to ensure patients’ needs are appropriately addressed in a timely manner. Knowledge of non-conveyance case characteristics may be useful to direct the focus of research that aims to inform and design effective, patient-centric models of ambulance healthcare delivery. A retrospective, observational cross-sectional study describing characteristics of non-conveyance cases occurring within an Australian ambulance service setting between 1 January 2019 and 31 December 2020. Of 1,533,453 adults attended and assessed, n=193,970 (12.6%) were not conveyed to the hospital. Dispatch initially prioritized 43.7% of non-conveyed cases as requiring an emergency (lights and sirens) response. Older people, aged 65 years and above, accounted for 44% of all non-conveyed patients. Pain was the most frequently recorded diagnosis, and less than 1% of all patients not conveyed were recorded as being referred to an alternative form of healthcare service. This study provides insight into characteristics of ambulance cases in an Australian jurisdictional ambulance service setting which resulted in non-conveyance during the impacts of the COVID-19 epidemic. These findings can be used to focus future investigations that aim to understand how evolving models of ambulance healthcare delivery can safely meet the needs of patients requesting ambulance services and enhance operational efficiency.