During a disaster, many pet owners want to evacuate their pets with them, only to find that evacuation and sheltering options are limited or nonexistent. This disregard for companion animal welfare during a disaster can have public health consequences. Pet owners may be stranded at home, unwilling to leave their pets behind. Others refuse evacuation orders or attempt to reenter evacuation sites illegally to rescue their animals. Psychopathologies such as grief, depression, and posttraumatic stress disorder are associated with pet abandonment during an evacuation. Health care workers may refuse to work if their animals are in danger, leaving medical facilities understaffed during crises. Zoonotic disease risk increases when pets are abandoned or left to roam, where they are more likely to encounter infected wildlife or unowned animals than they would if they were safely sheltered with their owners. These sequelae are not unique to the United States, nor to wealthy countries. Emergency planning for companion animals during disasters is a global need in communities with a significant pet population, and will increase resilience and improve public health.