The present paper aims to contribute to the knowledge concerning the seismic assessment of load bearing masonry buildings with reinforced concrete slabs. The final goal of the present research was to propose a simple, yet accurate, methodology to assess the seismic safety of existing masonry buildings. The methodology here presented was based on the so-called ICIST/ACSS methodology with major improvements such as the extension to load bearing masonry wall buildings and the consideration of the effects of one of the most common strengthening solutions for masonry walls, here referred to as reinforced plastering mortar, as well as the possibility of considering four levels of increasing refinement: global, by alignment, by wall panel and by wall element. An extended research was performed on the existing methodologies to evaluate the seismic structural risk of load bearing masonry buildings, briefly describing methodologies similar to the one proposed, namely all of those that have in common the fact that they are based in the physical comparison between the resisting and acting shear forces at all storeys and along the two orthogonal horizontal directions. A case study is presented to check the applicability of the proposed methodology. The case study showed that the proposed methodology is relatively simple to apply and has a sufficiently good accuracy when compared with alternative methodologies. The degree of refinement of the analysis (global, by alignment, by wall panel and by wall element) must be taken into consideration and successively more complex analyses may be required when the results of simpler analyses are inconclusive. [ABSTRACT FROM AUTHOR]