Campbell Fisher, 56, appeared at the High Court in Glasgow and was today ordered to perform 150 hours' community service and banned from driving for four years.
The court was told the victim's family did not wish Fisher to go to jail.
Fisher had previously admitted causing the death of Robert Cunningham by careless driving in Prestwick Road, Ayr, on November 19, 2010.
Mr Cunningham was crossing with the green man at a pedestrian crossing when he was struck by the ambulance.
Judge Lady Stacey told Fisher: "The events were a tragedy for Mr Cunningham's family and nothing I can do will lessen the grief his family must feel.
"I accept this has been a tragedy on your life too. I have read all the references from colleagues and family and listened carefully to the circumstances of the accident.
"In all the circumstances I do not find it necessary to impose a prison sentence in view of your previous good character and lack of previous convictions."
Fisher has worked with the Scottish Ambulance Service for 21 years, seven of them as a paramedic. His future with the ambulance service is uncertain.
The court had heard Fisher was driving an ambulance service rapid response car on the day of the tragedy. He had received a 999 call about a man complaining of chest pains.
Police investigators estimated the speed of Fisher's vehicle at the accident scene before braking as being 46mph and stated in a report: "The blame for this collision must lie entirely with the accused.
Seconds after he hit Mr Cunningham, Fisher was out attempting resuscitation without success.
It was later revealed the 999 call was downgraded to a non-emergency call on Fisher's on-board computer screen just moments after the fatal crash.