Over the last decade conflicts and terrorism-related emergencies have represented a new concept of disaster and a new resurgence involving a complex pattern of global changes and imbalances. Throughout the globe, healthcare providers are increasingly challenged with the specter of terrorism and the fallout from weapons of mass destruction. The previous experiences of terrorism acts connected to the World Trade Center (09/11/2001), Madrid, London and Sharmel-Sheik attacks highlighted the problems related to a possible terrorist attack in Italy. The prediction of a possible future terrorist attack drives the efforts of public policy and government founding. A mass casualty situation (MCS) usually is short in duration and resolves itself. Planning is essential to minimize the risks to patients during MCS. The Italian government organized a counterterrorism program involving all forces engaged in security and emergency to test the real capacity of the security and emergency plans to protect civil population in term of civil defense, homeland security and public healthcare preparedness. On September 23 2005 in Milan, Italy, there was the first official counterterrorism Drill, organized with all forces engaged in emergency and security. The Drill was related to a government security program to prevent and prepare a counterterrorism response to a possible future terrorist attack in some Italian major towns like Rome, Milan, Naples and Turin. The authors show how the drill was organized and how their Hospital participates to this first National Italian Drill.