Throughout the United States, at any given time of year, there are festivals, concerts, fairs, sporting events, and many other large and small events that gather or have the potential to gather large crowds. Under normal conditions, these events go on with few or no problems. When something goes wrong, however, either as a result of a natural hazard or a manmade hazard, then local emergency management becomes involved. These mass gatherings are also potential targets for terrorists. Multiple deaths and injuries at large public events have occurred consistently and over a wide spectrum of countries and types of events. Certain highly competitive sports events, particularly soccer, and rock concerts and festivals tend to produce spectator-generated incidents, while air shows and auto races tend to produce more participant-generated occurrences. In some instances, advanced assessment of, and planning for, these events failed to occur, or when they did, they failed to identify the potential for disaster, or mitigating or coping strategies for a major incident. The purpose of this manual is the prevention of injury, suffering, or death that may occur as a result of poor planning or preventable incidents at public events. This manual is intended to provide guidance for the management of risks associated with conducting events that involve mass gatherings of people and assist planners and organizers in making such events safe and successful. FEMA has prepared this manual for use by anyone planning or conducting a special event or mass gathering. This manual is intended to enable its users to ensure that adequate measures and systems are in place to prevent, reduce, and provide care for injuries, illness, and suffering that may occur. Many people, in addition to health personnel, contribute significantly to the success of a public event. Therefore, FEMA anticipates that this manual will be distributed to event promoters, managers, public and private organizations, emergency service personnel, government bodies, and any individual or organization that contributes to the planning of events. Wide distribution is encouraged, providing that individuals understand that the detailed contents of the manual are directed principally at managing the health and safety aspects of the event for all participants, officials, and spectators.