Disaster epidemiology reveals epidemic increases in incidence of disasters. Rare disasters with catastrophic consequences also threaten modern populations. This paper profiles natural disasters, transportation incidents, emerging infectious diseases, complex disasters and terrorism for their historical and future potential impact on Australasia. Emergency physicians are in a position to assume leadership roles within the disaster management community in Australasia. The Australasian College for Emergency Medicine is in a position to lead medical specialty advances in disaster medicine in Australasia. To optimize its impact in disaster medicine, the specialty and its College have opportunities for advances in key areas of College administration, intra and interinstitutional representation, disaster preparedness and planning, disaster relief operations, education and training programs, applied clinical research, and faculty development.