In this SASMA Podcast episode, host Aasha sits down with Dr Darren Green—Chief Medical Officer for Mediclinic Corporate Events and CMO to flagship races and rugby tournaments—to unpack how a city readies itself, medically and operationally, for the Cape Town Marathon as it bids for Abbott World Marathon Majors status. Dr Green lifts the lid on the real engine room of race day: ER24’s pre-hospital response, doctor–nurse route stations, a 28-bed finish-line race hospital with ICU capability and rapid cold-water immersion, and the live Venue Operations Centre coordinating police, traffic, disaster management, and medical dispatch in real time. He explains how spring weather, heat, wind, humidity, and radiant tar impact risk and performance, and walks through the most common clinical presentations—from heat illness, hyponatremia, and rhabdomyolysis to MSK overload and postural hypotension—plus practical prevention for runners. We also spotlight the 100+ UCT and Stellenbosch volunteers gaining frontline experience and the broader public-health legacy of hosting a world-class marathon in Africa.