Background <p>Effective emergency response is a critical challenge for healthcare institutions in conflict-affected areas. Strategic management has been recognized as a key factor in improving preparedness, coordination, and operational efficiency during crises.</p> Objective <p>This study aimed to analyze the association of strategic management and enhancing the effectiveness of emergency response in governmental hospitals in Gaza Governorate.</p> Methods <p>A descriptive-analytical design was employed. Data were collected through a questionnaire distributed to 77 administrative and supervisory staff from hospitals in Gaza and emergency committees at the Ministry of Health. The questionnaire had 19 closed-ended items covering strategic management and emergency response effectiveness, guided by the WHO Hospital Emergency Response Checklist, in addition to two open-ended questions. Reliability was high (Cronbach’s α = 0.93), and validity was confirmed by expert review.</p> Results <p>Findings revealed a positive association of strategic management on emergency response effectiveness, with an overall mean of 3.91 (78.2%). Highest-rated factors included adherence to assigned roles and responsibilities (91.42%) and decision-makers’ engagement (91.16%), reflecting professionalism, discipline, and leadership commitment. Key challenges identified were resource shortages, limited inter-team coordination, and weak logistical systems. Proactive planning, scenario-based simulations, and regular drills were found to enhance coordination, role clarity, and operational readiness.</p> Conclusion <p>Strategic management plays a vital role in enhancing emergency response effectiveness in complex and unstable environments. It fosters hospital resilience, strengthens inter-agency collaboration, and ensures continuity and efficiency of healthcare services during crises.</p>