The paper presents and discusses a methodology to judge the effectiveness of the preparednessactivities in case of accidents in road tunnels by considering the system from several points of view (i.e. structural/technical, organizational/human, and contextual). Due to the different nature of the criteria involved in the assessment activity, we chose to apply the Analytic Hierarchy Process methodology (Saaty, T.L. (2006). Fundamentals of Decision Making and Priority Theory with the Analytic Hierarchy Process, RWS Publications, Pittsburgh) that allows comparing and appraising quantitatively variables that are incommensurable and that may originate from distinct and separate areas. The paper identifies the hierarchic structure necessary to measure both the performance of the emergency response system forroad tunnel accidents and the weights for assessing their relative importance. Finally, the methodologyis applied to a case study on a transnational road tunnel between Italy and France to show a feasible evaluation of the sensitivity of the structure to the input variables in order to find the most valuable enhancing and improving actions.