Introduction: Earthquake is one of the commonest natural disasters and sometimes the most dangerous event in the world. In Iran, because of being on Alp-Himalaya earthquake belt, earthquake is common. In earthquake events, hospitals are as the first centers that their providing suitable and timely healthcare are determinant and can save lives and reduce mortalities. Also, having knowledge about hospital programs against natural disasters has an important role in decreasing damages. This study was aimed to determining TUMS hospital executive managers' knowledge and performance and their hospitals preparedness against earthquake events, and their relationships (2005-2006).

Methods: This is a cross-sectional, analytical-descriptive study explores all TUMS public hospital executive managers' -teaching and non-teaching- knowledge and performance and their hospitals preparedness against earthquake events. A checklist, questionnaires, and observation method were used for data collecting gathered data were analyzed using SPSS 11.5 software and correlation (Spearman correlation coefficient) tests.

Results: In all studied dimensions, average overall knowledge, performance of hospital executive managers' and average overall their hospitals preparedness level to confront earthquake events were (47/52%), (56/69%) and (49/54%), respectively. Managers' performance and their hospitals preparedness against earthquake events have been improved by increasing their knowledge, but only there was statistically significant relationship between managers' knowledge and their performance(P= 0.016). 

Conclusion: Hospital executive managers' knowledge, performance and their hospitals preparedness to confront earthquake events showed very low. Given the significant relationship between managers' knowledge and performance, it is important to develop and implement short term educational courses for hospital them to improve their performance to confront earthquake events.