Recent foreign disasters reinforce the argument that it is past time to distinguish conceptually post-earthquake “urban heavy rescue” (UHR) from the generic “search and rescue.” It is especially important to appreciate the problematic operational environment of UHR and the political as well as the lifesaving implications of UHR successes and failures. Effective UHR requires complex inter-governmental, public-private, and civil-military preparedness planning. At this point in time, UHR remains the weak link in the entire response chain to the inevitable major urban earthquake in the United States.