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The destruction caused by the earthquake can be widespread causing damage to telecommunication & power infrastructure, bridges & roads, water & sanitation facilities, and other services. Similarly, local administration during earthquake becomes mostly impaired especially after the destruction of majority of government buildings. The major earthquakes of Pakistan include Quetta Earthquake 1935, Kashmir - Khyber Pakhtunkhwa Earthquake 2005, Ziarat Earthquake 2008 and Awaran – Balochistan Earthquake 2013 which emphasized for the need of public and institutional preparedness at large scale. The objective of this paper is to assess the people and government earthquake preparedness in district Mansehra and recommend measures for its improvement. Historically, two high risks tehsils of district Mansehra (Balakot and Mansehra) were selected for this paper. A survey questionnaire was conducted using random sampling technique. The data was collected from six government departments and 498 local respondents. The results of the study reveal that government organizations have learnt lessons from the experience of past earthquake and thus increased their level of preparedness including emergency response system, early warning system, protection of assets and property, care for the human resources, addressing health issues, provision of shelter and logistics etc. Similarly, people are now well aware about the affects of earthquake disaster. The public preparedness level includes adequate knowledge about earthquake disaster, mitigation measures, alternative shelter arrangements and protection of resources. Based on the results of collected data and findings, the research study has proposed certain measures for further improving the public and institutional earthquake preparedness.