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Abstract Major earthquakes have occurred frequently in Japan throughout history, and the 2024 Noto earthquake is no exception. However, such natural disasters differ in some respects, and specific problems related to these events have also become clear. Kanazawa Medical University Hospital, which was the closest university hospital to the disaster area of the 2024 Noto earthquake, played a crucial role in serving the local community in the wake of the earthquake. The first method used to identify disaster-related patients is to tag them when they are examined by a physician. After confirming that a patient was eligible at the disaster-related patient-determination meeting, patients’ medical information was extracted from the tag name. A total of 421 disaster-related patients were transported and hospitalized by day 31. Fifty-two (14.4%) and 48 (13.3%) patients were admitted for orthopedic surgery and respiratory medicine, respectively. Forty (11.1%) and 38 (10.5%) patients were admitted to cardiology and nephrology departments, respectively. These four departments account for 49.3% of the total. The number of hospitalized patients in the nephrology and orthopedic surgery departments was high immediately after the 2024 Noto Earthquake. We also describe new hospital-specific initiatives and recommendations to improve Kanazawa Medical University Hospital’s system while sharing another hospital experience.