Nigeria has suffered from both natural and man-made disasters such as flooding, drought; civil unrest, genocide and insurgency; and the country is very important in the continent in terms of its population size, weak health systems and poor disaster preparedness. During disasters, hospitals play critical role by providing essential medical care to the injured in the communities.  This paper assessed the relationship between disasters and hospital safety in Nigeria. The study is a narrative review using secondary literature from PubMed, Medline and Google scholar databases. The search words were disaster, Africa, Nigeria and hospital safety. Hospital safety index (HSI) is a global diagnostic tool that provides a snapshot of the probability of functionality of a hospital during disasters. It has structural, non-structural and functional factors in addition to environment and the health services network dimensions with 145 items that can be assessed and grouped into three safety categories- high (A), average (B) and low (C). Category A with score of 0.00-1.0, requires preventive measures to maintain and improve safety; category B with score of 0.36-0.65 measures are required in the short time to reduce losses; category C with score of ≤0.35 requires urgent measures to protect lives. Nigeria over the years has experienced flooding, epidemic, insurgency, fire outbreaks and gas explosion among others with serious impacts. The flood of 2012 alone caused 363 deaths, 2.1 million displaced persons, 18,282 injured and damages of $16.9 billion. The challenges include large gap between policy and implementation, poor knowledge and education on HSI, lack of hazards vulnerability and capacity assessment, hospital building code issues, corruption and poor post-disaster analyses. It is a wakeup call for synergistic action by the relevant stakeholders to reduce risk, protect health facilities and save lives in Africa in general and Nigeria in particular.