This paper provides a distillation of the learning from thirty years of humanitarian response to earthquakes. It concentrates on issues of particular relevance in earthquakes. The paper assumes that readers are already familiar with the more general lessons in the aid sector such as the key roles of needs assessment, effective coordination, accountability and consultation with the affected population. The main intended audiences are operational decision-makers and relief programme managers working in the response to such sudden-onset natural disasters. Sadly, many of these lessons are not new.