PURPOSE: On November 23, 2010, Yeonpyeong Island was under artillery fire and mass civilian casualties developed. Incheon West-sea regional emergency medical center, dispatched a disaster team to deal with the casualties. The purpose of this study was to review the regional disaster response of this team to improve the operations of the National Disaster Medical System, Disaster Medical Assistance Team, and the Mobile Emergency Support Unit in case of future emergencies. METHODS: We retrospectively reviewed the disaster response upon bombardment of the Yeonpyeong Island and analyzed medical records of patients who treated by the disaster team at Yeonpyeong island. RESULTS: The disaster team and EMS were activated after the bombardment. Disaster team included two doctors, three emergency medical technicians, and one ambulance driver. The bombardment occurred at 14:34, and lasted for 30 minutes. The disaster team was dispatched at 16:40, and arrived in Incheon port at 17:07 and departed for Yeonpyeong Island with a fire engine and ambulance at 21:48. Our team reached the island the next morning and started to treat a patient. A total of 30 patients were participated in this study. The mean age of the patients was 49.4(+/-14.2) yrs old. Most of he patients are a mild case. Diagnosis was multiple contusion, acute stress reaction, cerebral concussion, rupture of tympanic membrane. Also: It may help to include data/analyses showing that there were inadequacies and problems with the system (time lag, insufficient medical training or supplies, etc.) CONCLUSION: This article is the first to report on the efficacy of the National Disaster Medical System after bombardment. From our analysis, the National Disaster Medical System contains many problems including access to the island, the equipment of communication, and the security of disaster team. This report shows that a review of our National Disaster Medical System is necessary to plan for future disaster scenarios.