Earthquakes are natural disasters that can cause severe damage to infrastructure and result in a large number of casualties, including multiple trauma patients. The initial approach to multi-trauma patients after an earthquake can be life-saving and plays a major role in determining their outcome. The aim of this article is to provide an overview of the initial approach to multi-trauma patients after an earthquake. The ABCDE approach helps healthcare workers to quickly identify and treat life-threatening injuries. This approach consists of five main steps covering airway, respiration, circulation, neurological system and deficiencies. These steps enable healthcare workers in emergency situations to quickly assess the patient condition and initiate appropriate treatment. In addition to the ABCDE approach, the initial assessment should also include the identification of injuries that require immediate attention. Once the initial assessment is complete, multiple trauma patients should be transported to a medical facility for further assessment and treatment. Rapid transportation of patients is also very important. In the aftermath of an earthquake, obstacles such as collapsed buildings and piles of debris can make it difficult to rescue patients. Therefore, health workers should use appropriate equipment and techniques to rescue patients safely and get them to hospital as soon as possible. Rapid transportation can prevent further harm to patients and increase their chances of survival and recovery. Changes in patients condition during transportation should be monitored and treated accordingly. In conclusion, correct and rapid first response can increase the chances of survival and recovery of multiple trauma patients after an earthquake. Healthcare workers should quickly assess the patient condition and initiate appropriate treatment using the ABCDE approach. It is also critical that patients are safely rescued and transported to hospital as soon as possible.