Abstract
BACKGROUND: The Hajj pilgrimage in Makkah, Saudi Arabia, is one of the world’s largest mass gatherings, posing unique challenges to healthcare systems. Healthcare professionals must provide care amid high patient volumes, diverse medical needs, and potential emergencies. Despite growing attention to preparedness, little research has explored the experiences and educational needs of frontline healthcare professionals in this demanding setting. AIM: To explore the experiences and preparedness of healthcare professionals who participated in the Hajj, with a focus on disaster response, training, and system-level challenges. METHODS: A qualitative exploratory study was conducted using semi-structured interviews with 17 participants, comprising nursing educators, paramedics, and physicians. Participants were purposively sampled and interviewed between January and June 2024. Data were analysed using Reflexive Thematic Analysis to identify patterns and insights related to disaster preparedness and clinical practice during the Hajj. FINDINGS: Four overarching themes emerged: limited disaster preparedness, a lack of communication and leadership, challenges in accessing prehospital care and patient management, and the need for cultural competence and workforce resilience. CONCLUSION: This study identified a lack in disaster training and education, and staff deployment. A systems-based approach and ongoing scenario-based training are essential to improve resilience and inform policy and education for future mass gatherings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-026-14390-9.