In November 1991 the Military Wing of Musgrave Park Hospital, Belfast, was the target of a terrorist bomb. Nine of the small military staff were killed or injured. The initial response was coordinated by doctors. The protocol for controlling the scene of a bomb is discussed, together with the overall management of the incident; the problems experienced when a hospital's treatment facility is severely disrupted are highlighted. Lessons for major incident planning and execution are reiterated. Blast injury and the immediate care of blast victims are reviewed.