Background: The disaster response environment in Haiti following the 2010 earthquake represented a complex healthcare challenge. This study was designed to identify challenges during the Haiti disaster response. Methods: Qualitative and quantitative study of injured patients carried out six months after the January 2010 earthquake in Haiti to review the surgical inputs of foreign medical teams. Results: Study findings revealed a need during the response for improved medical records and data gathering for regulation, quality assurance, coordination and resource allocation; wider adherence to standard patient referral mechanisms and protocols linking surgical service provision with appropriate hospital and community based rehabilitation services; a greater recognition of the impact of non-amputation injury, and the need for patients to have a greater say in their management and to be the keepers of their medical records. Key first steps to improving the international response are a minimum dataset and uniform reporting. Conclusion: This study showed that challenges for emergency medical response during the Haiti Earthquake involved issues of accountability, professional ethics, standards-of-care, unmet needs, patient agency and expected outcomes for patients in such settings: © Copyright Redmond © World Association for Disaster and Emergency Medicine 2012.