Between June 5 and 9, 2001, Tropical Storm Allison dropped upwards of 50 cm (20 in.) of rain on the Texas Medical Center (TMC) in Houston, causing the worst urban flood in U.S. history. The unprecedented rainfall event flooded hospitals, labs, underground tunnels and garages, and power stations, and resulted in excess of $1.5 billion in damages and the loss of decades of medical research. Tropical Storm Allison served as a severe wake-up call to management at the TMC. In response, they developed a hazard mitigation plan (HMP) to minimize the impact of natural and artificial hazards on the TMC campus and its member institutions in the future. Today, the TMC is the premier example of a world-class institution that has a working hazard mitigation plan. This paper discusses the impacts of Tropical Storm Allison (2001) to the TMC and the measures officials have taken to protect and upgrade the flood infrastructure as an example of hazard management for other large, vulnerable institutions. (C) 2014 American Society of Civil Engineers.