As the most important centers providing medical services during disasters and emergencies, hospitals have special structural complexities. Furthermore, the hospitals are exposed to many intrinsic and extrinsic hazards, including fire. On November 28, 2018, at 9:25 am (local time), a fire started in Ayatollah Taleghani Hospital of Ilam, affiliated with Ilam University of Medical Sciences, Iran. Immediately, to save patients’ lives and prevent injuries to them, the horizontal and then vertical evacuation was performed to transfer patients to other hospitals by helping the support organizations. No physical injuries or deaths were reported in this incident. The results of this case study showed that hospitals should be sufficiently prepared to respond effectively to accidents and disasters, so it is needed to prepare and practice response programs and train hospital staff and managers.