OBJECTIVE The Great East Japan Earthquake occurred at 14:46 on March 11, 2011, producing serious and widespread damage. To assess damages in hospital operating departments during and after the earthquake, we surveyed hospitals in this region. METHODS Questionnaires were sent to 415 acute care hospitals in Tohoku and east Kanto areas. The questionnaires elicited the number of perioperative patients when the earthquake hit, obstacles to continuing surgery, structural and nonstructural damage to the operating department, and the effect on routine surgery after the earthquake. RESULTS Of the 213 hospitals (51%) that completed questionnaires, 474 patients were undergoing operations during the earthquake, and 222 operations were canceled afterward. Risk factors for continuing operations, as reported by 102 hospitals, were tremors and electrical blackouts (odds ratio [OR]: 79.3 and 110.5; P < .01). In 154 hospitals, difficulties in performing operations after the earthquake were reported. Significant obstacles to the management of operations after the earthquake were characterized by infrastructure disorder scores, seismic intensity, disruption of electrical power and air conditioning, and damage to out-of-hospital telecommunications (OR, 0.46; P = .04). CONCLUSIONS Tremors and electrical blackouts were important risk factors for performing operations. Nonstructural damage, especially to out-of-hospital telecommunications, affected the management of the operating rooms. Hospital logistics are very important to achieve appropriate disaster management. (Disaster Med Public Health Preparedness. 2014;0:1-7).