Disaster psychiatry is an area of practice that seeks to apply mental health knowledge and expertise to the setting of disasters. Ministering to the psychological needs of a disaster-stricken community in the acute aftermath of a disaster is distinctly different from what it is required in dealing with the long-term aftermath months or years later. The context of service delivery, the relevance of psychiatric diagnosis, the clinical interventions, and the personal challenges for the psychiatrist are all vastly different from the rest of psychiatric practice. In order to help psychiatrists judge whether to engage in acute disaster psychiatry or prime them for how to engage in it, this paper reviews both the rewards and challenges of engaging in this work. Ultimately, the challenges outnumber the rewards, but the disaster psychiatrist sees rewards even in the challenges.