Abstract: Hospital buildings are considered to be the most challenging building facilities, and there are many uncertainties in the construction process, such as population trends, disease patterns, technological advances and clinical knowledge.Among them, the safety of buildings in the event of disasters is particularly important.The complexity, density and flammable materials of hospital buildings add to the fire hazard.In the event of fire, due to the differences in evacuation conditions of different personnel, It is very difficult to evacuate, so it is necessary to have possible fire hazards in hospital buildings and to establish comprehensive and reliable fire supervision.This paper describes in detail the technical route of building fire simulation and escape analysis in large hospitals, including model construction, ventilation analysis, fire simulation and evacuation analysis.The simulation analysis is carried out by taking a large hospital as an example to obtain the most unfavorable ventilation conditions.The results of temperature distribution cloud map, smoke distribution cloud map and evacuation route of each room in the fire process can provide technical route reference for the analysis of similar projects through project research.