Purpose:The objective of this study was to establish the relationship between the timing of admission to a hospital and the severity of injuries following an earthquake.Methods:It was a retrospective chart review of injured patients admitted to a tertiary care teaching hospital following the 2005 Pakistan earthquake.Age,gender,injury severity score,type of injuries,complications,operations,hospital stay and mortality were studied and compared at different time intervals using SPSS.Results:Most injuries were musculoskeletal [145 (59％)] vs.all other injuries,including minor lacerations [103 (41％)],but the percentage of non-musculoskeletal injuries was higher within 24 h (67％ vs.53％ respectively,p =0.4).Injury severity score (25 ± 10 vs.16 ± 9,p =0.01),multiple injuries [73％ vs.45％,p =0.05] and crush syndrome [20％ vs.03％,p =0.02] were significantly higher in patients admitted within 24 h.More patients with head and neck injuries were admitted within 24 h (27％ vs.18％,p =0A).Patients admitted within 24 h had higher complication rates (67％ vs.32％,P =0.01) as well as mean operative procedures (2.8 ± 1.9 vs.1.9 ± 1.9,p =0.08).Conclusion:Our study showed that patients admitted to a hospital within 24 h following an earthquake had more severe injuries and higher complication rate than those admitted after 24 h.