Influenza can be epidemics and causes a mass casualty. To responses that, health care setting must have a good preparedness for epidemics. Aim: To estimate the current state of influenza preparedness level in hospitals and primary health care centers, and health workers' perception of institutional preparedness in Ismailia city. Subjects and Methods: A cross-sectional study design was conducted at three hospitals and four primary health care centers in Ismailia city. 139 healthcare workers

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... ) were studied in primary health care centers and 176 HCWS in hospitals. Data collection tools included 2 questionnaires and 2 checklists appropriate to the study objectives. Results: The results of this study showed that hospital and primary healthcare workers (HCWs) in Ismailia assigned relatively low importance to personal protective equipment (PPE), and showed mixed attitudes (anxious but accepting) to the potential risk. The weakest domain in our hospital preparedness was health personnel and supplies while the weakest area of preparedness was for infection control among primary health centers. Concerning the Gini coefficient, our results demonstrated inequalities in the distribution of all resources at the hospital level with the higher level of inequality for physicians, Tamiflu and N95 mask (0.63, 0.56 & 0.46 respectively). On the other hand, the distribution of nurses and Tamiflu was moderate unequal distributed at primary levels (0.34 & 0.41 respectively). Conclusions: A higher level of institutional preparedness stood out to be an important predictor of individual preparedness.