Background: While the main concern of Iran has been the risk of drought, and the Iranian authorities are always trying to find the solutions and prepare projects for the supply of their citizens' water, this country suddenly experienced a massive flood that affected more than 31 provinces in 2019. This study was conducted to extract lessons learned from the health system response and management of Iran in the 2019 floods. 
Materials and Methods: This report was designed and implemented using a multi-method model with both quantitative and qualitative methods. 
Results: In this year, more than 42 million Iranian citizens were affected by the flood. The medical centers provided services for more than 1137000 people. Also, 85 people died and 19 outbreaks were identified in the flooded areas. 
Conclusion: Preventing flood victims to have access to humanitarian help and illegal measures concerning international cooperation seems to be immoral and at least sanctions should not be included in helping people in disasters, especially the health system is considered. Unfortunately, there is still a lack of ability to predict climate change, and it is necessary to focus on this issue. the “all-hazards” approach should be taken into consideration for the effective management of these incidents.