BACKGROUND: A massive earthquake struck North Pakistan on 8 October 2005. The objective of this study was to evaluate the types of injuries and the procedures carried out on the admitted casualties, and to present recommendations based on these experiences for improvement in disaster preparedness and management. This is a descriptive study conducted at the Military Hospital, Rawalpindi. METHODS: Inclusion criteria included all patients who required admission for treatment. Patients who had minor injuries not requiring indoor treatment and those who were dead on arrival were excluded from this study. The files of admitted patients were analyzed for type of injuries, procedures performed, complications, and causes of death. RESULTS: The total number of patients received was 1698, of which 862 (50.8%) were admitted. A total of 2289 operations were performed including 1046 (45.7%) major interventions. Sixteen (1.5%) amputations were necessary. Seventeen deaths (1.9%) occurred in hospital, while 76 dead bodies were received. CONCLUSION: After the initial days of life- and limb saving, it is important to quickly divide the manpower into teams with a major emphasis on plastic, orthopedics and spinal surgery, to start shifts and to utilize the volunteer manpower early and judiciously. Prevention of tetanus is essential.