Objective On 12 May 2008, the Wenchuan earthquake, registering 8 on the Richter scale, hit the Sichuan province, China. Management of the rescue efforts and characteristics of casualties were studied.

Methods This is an observational descriptive study. Data were gathered from health services reports from the day of the earthquake on 12 May to 8 September 2008, as well as from field research. Information on the types of injuries from other studies of this earthquake was also reviewed.

Results Casualties were concentrated in the hardest-hit areas of the province, and the number of deaths in those areas accounted for 77.10% of the total. Within the first 7 days, the types of injuries reported were mainly within the trauma/wound category (74.1–98.6%). After the seventh day, acute upper-respiratory-tract infections were the leading problem. Rescue forces included local, regional, military and foreign health personnel. The rescue work followed the principle of ‘centralising the wounded, the experts, the resources, and the treatment,’ and a three-level medical evacuation system was established.

Conclusions The Wenchuan medical rescue effort presented several problems. The experience is reflected in these points: (1) establish an effective command and communication centre to ensure that medical rescue resources are deployed in time; (2) treat the wounded within the first 7 days; (3) prepare healthcare resources for both surgical and general medicine services; (4) establish contingency rescue plans with a coordinated effort; (5) insist on the principles of triage and adopt flexible evacuation and transfer methods.