On Sept 2, 1985, Hurricane Elena struck the Gulf Coast of Mississippi. We conducted a retrospective review of Emergency Department logs for a one-week period before and a two-week period after the storm to determine what additional support would be needed to manage such a disaster. There was a significant increase in the number of patients treated for psychiatric problems and trauma. These findings are similar to the results obtained in a study at the same hospital after Hurricane Frederic in 1979.