Aceh province is vulnerable to multiple hazards. Despite improvements in disaster preparedness efforts including the early warning system (EWS) following the catastrophic 2004 earthquake-tsunami, ineffective disaster responses still occur here. An EWS is essential to provide early disaster information to people in order to respond appropriately. An integrated EWS consists of risk knowledge; monitoring; dissemination and communication; and response capability elements. This study investigates how Aceh’s disaster management and preparedness have evolved since 2004 focusing on its EWS and in particular how the contemporary integrated EWS approach has been incorporated into its development and operation. In-depth interviews, along with review of relevant policy and procedures were conducted to understand current practices and existing governance and structure of EWS design and operation. Findings suggest that a multi-hazard EWS is not well developed and a linear EWS model is prominent. Dissemination and response elements dominate the EWS design and operation with a lack of ongoing risk assessment that incorporates vulnerability concepts and some important governance issues that impact on response and capability. Key recommendations are made for review of policy and practice for Aceh governments at provincial and district levels and other relevant stakeholders to improve the current EWS.