Critical facilities, such as hospitals, play a crucial role in the socioeconomic and psychological recovery of the population after a disaster. Hospitals are considered important due to their roles in saving lives in the affected population and must be able to withstand hazards and remain functioning during and after a disaster. This article assesses earthquake preparedness of hospitals in eight Japanese cities using a questionnaire survey. The questionnaire consists of six parameters and 21 indicators from the “four pillars of hospital preparedness” including structural, nonstructural, functional, and human resources. The results show that the majority of the respondent hospitals fulfill the functional preparedness, which is useful during the emergency period of a disaster, while the other three pillars—structural, nonstructural, and human resources—need to be strengthened. This study helps to assess the status of disaster preparedness as well as the gaps for these hospitals in the Tohoku and Nankai Trough regions, drawing lessons from the Great East Japan Earthquake and Tsunami of the Tohoku area. This status and the gaps are used as a departure point to indicate how to enhance preparedness and resilience to future disaster risks.