In the aftermath of the September 11 terrorist attacks and the dissemination of anthrax in 2001, the ability of the US health‐care system to provide an effective and coordinated response and evacuation capability to mitigate mass casualty or complex incidents came under intense scrutiny. More recently, the devastation caused by Hurricane Katrina and the mass disruption of public health and medical services along the Gulf Coast spotlighted the need for cohesive strategies that focus on mounting effective evacuation and response for catastrophic events. Determining the most effective evacuation plan for a large public facility requires in‐depth analysis of multiple interdependent and competing factors. Determining the best routes, foreseeing potential problems, addressing the chaos/panic factor, and orchestrating the evacuation are all critical aspects that should be evaluated in a well‐developed disaster management plan. The success of the evacuation of 80,000 in the stadium Santiago Bernabeu in Madrid, Spain within 7 min sheds some light on the potential to save many lives through careful planning and proper evacuation responses. Emergency responders and coordinators must be equipped with such knowledge so as to protect the regional population during critical incidents. In this article, we seek to understand the elements that influence evacuation planning, issues faced by decision makers, as well as methodologies from the field of operations research that are leading to more effective planning and execution.