Purpose – To evaluate disaster preparedness and surge capacity perception at the Armed Forces Hospital Southern Region (AFHSR), Kingdom of Saudi Arabia. Design/methodology/approach – A cross-sectional study was conducted using an instrument assessing perceived hospital preparedness and surge capacity within the AFHSR, which was developed based on a review of the literature. The items used in this instrument were adapted from the framework and thematic findings of Shabanikiya et al. (2016), covering eight domains: surge capacity, command and control, human resources, triage, communication, logistics and supply, safety and security and recognition and continuity. A total of 600 healthcare providers’ valid responses (response rate: 30.0%). Data were analyzed using descriptive statistics and correlation analysis. Findings – High awareness of disaster policies (89.5%) and prior real-world disaster exposure (58.5%) were reported. Strong perceived preparedness was observed in triage (1.12 ± 0.263) and safety and security (1.13 ± 0.266). Lower perceived performance was noted in human resources (1.22 ± 0.322) and communication training (1.19 ± 0.202). Awareness of the disaster plan significantly correlated with preparedness perceptions (r = 0.407**, p < 0.001), and awareness of the disaster policy significantly correlated with preparedness perceptions (r = 0.448**, p < 0.001). Research limitations/implications – The single-center design and moderate response rate may limit generalizability. Results underscore the need for targeted improvements in workforce planning and structured communication training to strengthen institutional resilience. Practical implications – Findings provide actionable guidance for hospital leadership to enhance surge capacity, optimize human resource strategies and reinforce communication frameworks. Social implications – Strengthened disaster preparedness improves patient safety, operational continuity and community confidence during public health emergencies and mass casualty incidents. Originality/value – This study delivers a structured, domain-based benchmarking of perceived preparedness in a major Saudi military hospital, contributing regional evidence to the limited literature on hospital surge capacity and disaster readiness.