Abstract : Arbaenea is a religious observance that occurs forty days after the day of Ashura (started from day seventh of Safar till forty of it), Arbaenea performance has been banned in some periods, the last of which was when Saddam Hussein, (a Sunni who ruled as an Arab nationalist, clashing with Islamic revivalism) was president of Iraq. For nearly 30 years under Saddam's regime, it was forbidden to mark Arbaenea publicly in Iraq. Following the 2003 invasion of Iraq, the observance in April 2003 was broadcast worldwide. Huge numbers of Shia Muslim gathered in the Iraqi city of Karbala, therefore the history of the Arbaenea a number of specific health relate issues have arisen, such as size of gathering, diversity of population, climate and health facilities in Karbala (most important factors). To assessment the challenge between what we did and at which level of medical service offer and what our target and how achieved our goal. Design of study is retrospective study of 42000 patients collected from 18-October to 22 November 2018 ( ميلادي) in Imam Hussein medical city hospital, data collected from registration of emergency department. Age: range of patients age from 1-70 years old, we divided the patients as sub group every 10 year, (21-30 old) is the largest percent. gender: male to female ratio is (65.65: 34.4), nationality: more percent of nationality is local visitors, followed by Iranian. The main presentation of patients is abdominal pain represented 61.3%. According to medical services is 74% related to medicine while 26% of cases related to surgery. chest x-ray investigations percentage utilized and performed in the hospital during Arbaenea in 2018 is total performed that represented 30.9%. Duration of hospital stay of the study patients is Less than 24 hours that represented 98.5%, the more post-management outcome of the study patients is discharged well is 35274 that represented 85.9%. Our results show increased incidence and prevalence of medical and surgical emergencies so we determined our power and weak point, and how to deal with it and organize our preparedness, guideline and communication center.