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There was an increase of about 30% in emergency calls over the weekend, West Midlands Ambulance Service says.
About 8,000 calls were made across the region at the weekend, about 1,800 more compared to the same time last year.
There was a 53.7% rise on Saturday in Birmingham and the Black Country and nearly a 40% increase in those areas over Friday, Saturday and Sunday.
A spokesman for the service said there was an unprecedented demand during the cold weather.
'Very difficult'
There were increases over the weekend of 27.9% in Shropshire, Herefordshire and Worcestershire, 19.9% in Staffordshire and 13.2% in Coventry and Warwickshire.
Ambulance service chief executive, Anthony Marsh, said: "All staff are working flat out around the region to meet the extraordinary demand and are trying to do their best in very difficult circumstances.
"Staff are tired and also sickness levels are increasing as they themselves become the victim of the norovirus and other stomach bugs that are around.
"I am urging the public to stop and think very very carefully before dialling 999 - is your condition of an emergency nature that requires an immediate 999 medical response?
"We would ask that you use common sense and use other health resources where appropriate."
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