Background: The most common and largest religious mass gatherings in Iraq are Arbaeenia and Ashura, the risk of various health-related problems increased during such events. This study aimed to describe the medical presentation among participants of the Tuwairij Run ( Ashura Day) in Karbala City, Iraq, 2024.Methods: We conducted a cross-sectional study on all health outlets of the Mass Gathering Medical Center.  The data were collected on the participants in the Tuwairij Run on the 17^th of  July  (Ashura Day),2024 who attended the selected outlets including the demographic information, medical presentations and types of services provided by selected outlets.Result: A total of 1058 patients enrolled in our study with a mean of age 37.4 years± 13.7 and 86% (912/1058) were male and a higher percentage of patients were in the 20-29 years age group. More than 61% (650/1058) had a history of chronic diseases and more than two-thirds (730/1058) of patients complained of various symptoms such as headache (461/1058), backache, joint pain (455/1058) and heat stroke (370/1058). Most attendees asked for rest ( 83.1 %), more than one-third of them were treated with analgesic drugs and only 0.7% (8/1058) were referred to the hospital.Conclusion: Most of the participants in this activity were male, young, and middle-aged age groups and a high percentage of them had chronic diseases. The more frequently reported presentations were joint pain and heat stroke. The attendance for these outlets didn’t seek for provision of health services only but also for rest, drinking water, and foot massage. Implementation of real-time surveillance and health promotion among participants is recommended.

Keywords: mass gathering, Tuwairij Run, Ashura Day, Karbala, Iraq surveillance