Syndromic surveillance of emergency department (ED) chief complaints and over-the-counter (OTC) medication sales was reinstituted in the Austin area in the fall of 2010. In 2011, the Austin area was hit with three natural disasters: a winter ice storm; a summer of extreme heat/extended drought; and a week of significant wildfires. Each disaster varied greatly in type, size, intensity and duration. The Austin/Travis County Health and Human Services Department (A/TCHHSD), in partnership with Austin/Travis County EMS (ATCEMS), was able for the first time to provide near-real time data to emergency managers on the potential health impact during each of the 2011 disasters using the syndromic and EMS electronic data systems. The data were used to provide situational awareness and guide selected response actions during the course of the disaster, as well as document potential areas for future mitigation efforts.