Introduction: In the developed and modern world, all things are depended on complicated and risky technology. Hospitals are also among the high-risk areas that observances of safety considerations in different hospital section lead to reduce likely risk and lawsuits. Central heating system is like a hospital hearts that not only helps to create air conditioning but also helps to improve patient's condition. The aim of this study was to detection of hazards and risk assessment by ETBA method in central heating System in Kashan Shahid Beheshti hospital in 2013.
 Materials & methods: This case study was conducted in the Kashan shahid beheshti hospital central heating system in 2013. ETBA method was used to hazards identification and risk assessment. Required information for this study was collected by field observations, interview with staff and engineers, energy checklist, investigation of technical documents and available maps by investigation team. Findings: overall, 8 energy and 35 potential risks were identified that among them, the risk of 12 hazards was estimated unacceptable, 20 risks was estimated unfavorable and 3 risks was estimated acceptable.
 Discussion & Conclusion: regarding to high number of identified hazards and associated risks which is related to them it is necessary that corrective measures to be taken to reduce the risk of hazards level in this place.