On December 26, 2004, a massive earthquake that registered 9.2 on the Richter Scale struck in the Indian Ocean off the coast of Aceh, Indonesia, spawning a tsunami that slammed into the island of Sumatra and caused unprecedented death and devastation. The Study of the Tsunami Aftermath and Recovery (STAR) is designed to provide rigorous scientific evidence on the immediate and longer-term impacts of the earthquake and tsunami on the health and well-being of the population living along the coast of Aceh and North Sumatra, Indonesia, before the earthquake. Building on a population-representative large-scale survey of over 20,000 respondents before the tsunami, STAR has followed survivors annually in the first 5 years after the tsunami and then every 5 years thereafter. The study documents the immediate consequences of the disaster and the longer-term consequence. We examine mortality, family disruption and relocation, fertility and community re-population, social and economic well-being, physical and psycho-social health, including biological measures of cardio-metabolic risks, cognition and cognitive aging.