The increase in the number of inhabitants in the cities as a result of increasingly pronounced rural-urban migration and their concentration in densely populated areas in modern societies, nowadays, has led to an increase in the need to be alert to the impact of catastrophic natural events, earthquakes in particular. The devastating earthquakes that have hit the territory of Europe in the last 20 years have led to an increase in interest and expansion of knowledge about the seismic vulnerability of buildings in Europe. In this study, a review of the seismic risk assessment in the city of Strumica (the largest town in the Southeastern planning region and the tenth largest city in North Macedonia [1]), regarding hazard, exposure, and vulnerability of buildings, with a focus on PHI “General Hospital Strumica” is presented. The proposed methodology for seismic risk assessment consists of defining hazard assessment method to estimate the maximum level of ground motion that could occur at the site, collecting and harmonizing available data for the existing build construction fund in the city and developing tools and methods, based on which an exposure model of the city is created and fragility models are applied to further estimate the expected damages to the buildings located in the city. The results will allow a better understanding of the level of vulnerability of the existing buildings in the analyzed region, emphasizing the importance of socio-economic variables. The collected database could be updated and further developed.