Fire is one of the most devastating disasters.The occurrence of fire in residential, commercial, and industrial buildings can cause significant human, financial, and environmental losses every year[
1]. It also affects social development[
2]. The direct economic losses caused by a fire is five times greater than that of an earthquake, and in terms of frequency, fires rank first among all world events[
3]. Reports indicate that 50% of fire-related casualties occur within buildings[
4]. Hospitals are complex and potentially vulnerable structures that must be sufficiently prepared to respond to predictable and unpredictable events[
5]. The safety of healthcare facilities is classified as sensitive and vital[
4,
6]. Due to the presence of medical gases, flammable liquids, and electrical equipment, hospitals face a higher risk of fire compared to other types of buildings[
7,
8]. Numerous factors have caused severe damages and deaths in hospitals in case of fire accident; including the presence of vulnerable individuals, the necessity for uninterrupted services, limited knowledge of firefighting techniques, the rapid spread of fires, and the substantial smoke emissions[
9,
10,
11,
12]. Hospital fires frequently lead to extensive damage, casualties, and significant financial burdens due to the costs of equipment procurement and replacement[
10]. Therefore, fire safety has become one of the most significant challenges for designers and users of these facilities[
13]. Based on the information obtained from the reiterated fires in hospitals, the main factors causing fires in these places include incidents such as fires in trash cans, smoking, fires in the kitchen, and electrical system failures[
14]. Furthermore, numerous studies have assessed hospital safety level. In a study conducted by Lari et al., the review results showed that the hospitals under study, have a weak safety level and require immediate action to protect patients and staff[
15]. The study by Hokamabadi et al. (2017) revealed that the safety of buildings, people, and activities is at its lowest level, with the highest risk and fire potential directed towards people[
16]. In a study by Sarsangi et al. (2013), it was found that the fire risk for individuals in all units is greater than 1, indicating a high risk of fire in the hospital complex with potential intolerable damage in case of a fire[
17]. In a study by Bashyal et al. (2022), it was found that the hospital has insufficient firefighting equipment and lacks adequate preparedness to deal with fires[
18]. However, studies show that by implementing safety principles, 75% of these fires are predictable and preventable[
19]. Hashemi (2020) conducted a study on a fire incident in an office building using the Fire Dynamics Simulator (FDS). The study found that detectors speed up evacuation, while sprinklers reduce damage. Delayed evacuation can result in risks such as decreased visibility and inhalation of toxic gases (HCl, CO, and CO2) [
20]. In another study conducted by Guangxia Hu (2020) focusing on high-rise residential buildings, the findings indicated that during the initial 60 seconds of a fire incident, the area surrounding the fire is conducive for evacuation. Moreover, the state of the door in the room where the fire originated significantly influences the successful evacuation of individuals[
21]. Therefore, using suitable methods to identifying hazards, evaluating consequences, assessing the risk, and implementing technical and managerial measures to control incidents can greatly reduce fire damages. One of the most critical and challenging areas during emergencies, in hospitals is the Neonatal Intensive Care Unit (NICU), where the most vulnerable population, infants, receive specialized care. These infants encounter various medical issues, and ensuring proper temperature regulation, respiratory support, cardiac monitoring, and other essential interventions are crucial for their survival. As a result, discharging these infants in case of emergencies, poses one of the most demanding challenges in emergencies[
22,
23]. Chowdhury (2013) examined 34 fires in Indian hospitals, and found that that they occurred in areas with oxygen gas near patients and electronic devices, especially in the NICU and ICU units[
24]. The outcome of fire accidents is influenced by factors such as heat generation, smoke, and dispersion. Obtaining this data is complex and is typically done through two methods: conducting real (live) fires in structures to measure temperature, smoke levels, and pollutant emissions with sensors. this approach is a costly and time-consuming process. An alternative method, has gained attention among fire engineering experts, is simulating fires in buildings. This method avoids actual fires, reduces costs and time, and eliminates the risk of fatalities entirely[
20]. One practical approach for simulating fire consequences is Computational Fluid Dynamics (CFD) studies,which have various applications in fluids simulations. Due to the complexity and time-consuming nature of CFD calculations, specialized software is utilized to enhance accuracy and speed. Pyrosim is a CFD tool based on FDS which is commonly used for fire simulation in indoor building spaces[
25]. This software can predict temperature, visibility, and toxic gas levels before and after a fire, allowing for analysis of fire scenarios in locations like metro stations, residential, commercial, and hospital buildings[
26]. Given the significance of fire safety in hospitals, the aim of this study, was to numerically simulate the fire behavior and evaluate the efficiency of control devices in the neonatal intensive care unit (NICU). To demonstrate the applicability of the method, a practical CFD study was conducted in a hospital at Bushehr province in Iran.