Roll-in cots having wheel alignment mechanisms are disclosed. According to one embodiment, a roll-in cot includes a support frame, a pair of legs pivotably and slidably coupled to the support frame, and a pair of hinge members that are pivotably coupled to the support frame and to one of the legs. The roll-in cot also includes a wheel linkage pivotably coupled to the pair of legs and a wheel alignment mechanism. The legs and the hinge members pivot relative to one another in a relative angular rotation ratio and the wheel alignment mechanism rotates the wheel alignment mechanism relative to the hinge members at a reduction ratio. The relative angular rotation ratio of the legs and the hinge members is approximately inverse to the reduction ratio of the wheel alignment mechanism.