The main purpose of this study was to examine the current state of facilities for trauma response. This was achieved through establishing the current urban planning considerations and spatial design requirements for such facilities and thus being able to establish the challenges being encountered as well as consider appropriate interventions for efficient trauma care. Currently, the network of major medical emergency facilities in Nairobi were designed and built decades ago which are currently facing challenges of medical care due to growth in population and advancement of treatment technology in the County of Nairobi. Many facilities have already existed beyond their useful shelf life. It is for this reason that most of this facilities are not able to fully address the current challenges of trauma / emergency. Relevant literature on the study topic from different primary and secondary sources have been reviewed with intent purpose of informing the researcher. Case study approach was the most suitable for this research and it’s from this that the major findings identified were issues to do with expandability and flexibility of the case study hospitals which included Kenyatta National referral hospital, Mater hospital and The AgaKhan University hospital. The key recommendations for addressing the current state of emergency facilities were established as accessibility, circulation and spatial organization which influence its efficiency.