Introduction: Earthquakes are one of the most devastating disasters Iranians encounter, and the Bam earthquake was the worst during the past 100 years. Rasoul Akram Hospital, a general university hospital and trauma referral center, received the largest number of Bam earthquake victims of all capital university hospitals. Methods: A checklist was prepared and data were gathered by direct contact with victims, medical staff, and managers, or indirectly by reviewing patients' charts. The data was processed and presented in a descriptive manner. Results: The emergency department was evacuated as soon as the event was announced. Elective patients were discharged from other wards, emergency department physicians were doubled, and proper nursing and other staff were assigned to the emergency department.Nearly four hours after preparation, the first group of victims arrived. A total of 259 patients were admitted. All patients were triaged twice by predetermined teams, received emergency department cocktail, and had samples taken. Based on triage, patients were classified into three groups. Those who had urgent life/limb threatening conditions were transferred immediately to the operating room, critical patients without operable problems were kept in monitored beds in the emergency department. And the third group consisted of non-urgent patients who, after primary stabilization, were transferred to regular floors. On the second day, the largest burden of patients arrived (150 patients <10 hours), so 2,600 square meters of unused space was prepared as a disaster area, and victims from all parts of the hospital gathered in this area, except for those needing special considerations. Emergency physicians visited all of these patients at least twice daily. Other specialties were summoned based on clinical needs. Overall, there were 42 severely injured patients and five mortalities, two of which were dead on arrival. In the first week, 96 major operations were performed.In the recovery phase, the emergency department had to act as a shelter for many victims, which accounts for the increased average length of stay (13.1 days). Conclusion: Although there was no pre-existing disaster plan, emergency physicians played a great role in providing better care, resulting in higher patient and other medical staff satisfaction, according to national comprehensive studies.