Galveston, Texas, was landfall for Hurricane Ike in September 2008, the second most severe, natural disaster to strike the Texas Coast. The University of Texas Medical Branch sustained flood damage in over 1.2 million square feet of academic, research, and hospital/clinic buildings. This resulted in interruptions in community healthcare, medical classes, nursing and allied health schools, and ongoing research. This presentation describes the activities at UTMB prior to Ike, including patient, staff, student and laboratory evacuations, and the immediate and ongoing recovery efforts.