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Evaluating of health status and explore the challenges of health problems that threaten human life following disasters and major earthquakes providing windows of opportunities for health care providers in future planning of disasters. The main purpose of this report was to survey the environmental sanitation statues after 200 days of the affected populations in earthquakes of East Azerbaijan, northwestern of Iran, 2012. The survey was carried out in earthquake zones 200 days after the occurrence of the earthquake. A single stage cluster sampling from among 95 villages damaged in the earthquake of 2012 East Azerbaijan of three towns Ahar, Varzeghan and Heris were selected. The data were collected with questionnaire, site visits and evaluation of water and sanitation. In a twin Earthquake, East Azerbaijan province that 399 villages of Ahar, Varzeghan, Heris, Tabriz and Kaleibar cities were affected and 356 (89.2 %) villages were destroyed between 30-100%. Evaluation of water and sanitation infrastructure after 200 days, shown that only half of these villages consumed healthy water with high coverage and adequate. Half of the villages in 200 days after the earthquake were covered safe drinking water (treated drinking water). The bacteriological quality of drinking-water supply of the affected area was assessed in randomly collected 146 samples from this region and ten (6.8%) reported as unsuitable. Solid waste management facilities in residents have not been acceptable that affect public health. Solid waste disposal was done by district residents (cooperation rural residents) 68.4%, 36.8% and 76.3% in Ahar, Varzeghan and Heris, respectively. Overall, the impact of infectious and communicable diseases after Earthquake was reported 42.1% (16 villages) in the Varzeghan. The lack of geographical view with a focus in mountainous and rural areas, partial support and dispersion of earthquake-stricken people in affected villages and lack of participatory need assessment and pre-crisis coordination among various organizations led to negative effects of environmental factors on health status in villages. Providing intra-sector coordination for waste management with a sanitary disposal of sewage and detection hazardous materials aftermath as well as immediate measurements in the water supply system are necessary for health promotion of the affected population in the disaster region.