There are many issues in a hospital evacuation, related both to patients conditions and to building complexity. Moreover, as consequences of the fire, there may be delays in surgeries and in medical diagnoses or interruption of treatment for both inpatients and outpatients. This work identifies and assesses problems that arise in the egress from the ward located at third floor of the University Hospital Campus Bio-Medico of Rome, using Pathfinder and its powerful tools. First of all the structural design of the ward has been set, loading the maps in the software. The occupants have been described by their standards patterns (i.e.: nurse, doctor, geriatric inpatient, visitor) giving the real situation observed in a 2/3 days’ survey of the ward. A maximum of 116 person could be found in the ward at its full capability. Five variables have been used to describe each type of occupant: speed, shoulder width, current door preference, reduction factor, comfort distance, giving to all the other variable the default value. Two different fire scenarios were created (fire in the electrical room and fire in the local kitchen) and consequently people had a different behavior in each one. Finally, on the basis of the different type of actions that could be set in the software, a sequence of actions was created (for instance: wait, go to) for every single person. It was found that the time needed to fully evacuate the ward was of approximately 8 minutes, far behind the fire resistance time of the structures. More than that, there was an overcrowded area in the ward that acted as a bottleneck: the smoke proof enclosure; this area is intended to separates the two nearby wards and, although built according to the Italian fire department regulation, it holds back people and beds. Some structural and technological solutions have been suggested on the basis of this outcomes.