Olof Schoon, Leonardus Bijlsma and Richard Engelsbel brought drugs in to the UK concealed behind panels in the bogus ambulances.
The smugglers were arrested after a raid by officials in June in Smethwick, West Midlands.
All men were sentenced on Friday at Birmingham Crown Court.
Father-of-three Olof Schoon, 38, from Amsterdam, received 24 years in prison.
Leonardus Bijlsma, a 55-year-old father-of-four from Hoofddorp and described as Schoon's "right-hand man", received 28 years.
Richard Engelsbel, 51, from Amsterdam, was given 18 years after admitting acting as driver on 25 smuggling trips purporting to be journeys to pick up injured patients.
Sentencing the men, Judge Francis Laird said the "meticulously planned" conspiracy tried to import drugs into the country on a "truly colossal scale".
A raid that took place in June by officials from the National Crime Agency found cocaine worth £30m, heroin worth £8m in individual deals and ecstasy tablets and crystal worth £60,000 in the fake ambulance used by the men.
The men's operation involved a fleet of fully taxed and insured adapted ambulances, which were created in the Netherlands.
Fake invoices and paperwork for false patient transfers to The Royal London Hospital were produced by Schoon's company, despite the hospital having no records of any trips, with false addresses and phone numbers for patients also made.
The operation ran from April last year and at the time of the arrests Schoon was believed to have made 39 separate journeys.
Three Dutch men have been jailed following a £1.6bn UK drug smuggling operation involving a fleet of fake ambulances.