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Hurricane Ian landed on September 28, 2022, in the Fort Myers area as a Category 4.9 hurricane, just two miles per hour less than a Category 5. The 148-mph winds with 15-foot storm surges were catastrophic, pushing water ashore from the Gulf of Mexico, tearing through homes and businesses along the coast, and making its way inside hospitals and other medical buildings. During the storm, the municipal water supply and the power failed. The initial assessment indicated that the timeline to repair these critical utilities was indefinite, resulting in Lee Health receiving evacuation orders for their five hospitals. This session will provide insight into the challenges and decisions that the health system faced before landfall and during the response, evacuation, decompression, and eventual repatriation of patient phases of this incident.