This study explored public relations and strategic communications in communicating health issues during the war in Tigrai. Public relations have the power to influence public opinion, decisions, and policymaking including health-related behavior and perceptions. Henceforth, the way health issues are communicated by PR during the war is worth studying. This study has mainly employed a quantitative research method to gather data. In addition, qualitative data has been employed to explore the roles of PR practitioners and the challenges faced. The findings showed that news releases and speeches have been dominantly used as communication tools. Most of the communication tools dealt with Emergency, Malnutrition, Diabetes, and Vaccination themes. Findings also revealed that mainly, health officials, NGOs, media channels, and community members have been employed as PR sources. Results further showed that community-strengthening approaches and didactic health education campaigns have been predominantly used while post-crisis communication management and advocacy approaches were minimally used. Finally, results revealed that PR practitioners have faced many challenges including the potential risk of life during the war. Also, the challenges were information and communication blackout to access and gather information. And, lacks of financial and human resources were other challenges as salary was cut in Tigrai due to the de facto blockade. It can be deduced that though the theme and the main focus of the world was facing the COVID-19 pandemic, the main themes of the public relations practitioners in Tigrai, Ayder Hospital were the diseases that were not WHOs priority.