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Emergency decision making problem is a crucial issue of emergency management and is a valuable academic research topic. Although some research has been conducted, there has been no attempt to solve emergency decision making problems on the basis of analyzing the influence of alternatives on the development and evolvement of emergency. In this paper, a novel FTA-based method is proposed for risk decision making in emergency response. In the method, firstly, a fault tree of the undesirable state of emergency is constructed, by which the influence of alternatives on the emergency can be analyzed. On this basis, the probabilities that the undesirable state will occur given that different alternatives are chosen are estimated. Then, according to the determined probabilities, the overall ranking values of alternatives are calculated based on multiple criteria risk decision making (MCRDM). Furthermore, a ranking of alternatives is determined according to the overall ranking values. Finally, a practical example is used to illustrate the feasibility and validity of the proposed method. The proposed method overcomes the limitations of existing methods that the influence of alternatives on emergency is not considered, and enriches the theories and methods for emergency decision making.