Nepal is in one of the most active earthquake regions in the world. Nepal's current non-earthquake-resistant infrastructure, lack of sufficient modern communication networks, and limited facilities and manpower in the medical sector are the major threats to life and property during a major earthquake. On March 31, 2010, under the auspices of three leading Nepali diaspora professional organizations in the United States of America--American Society of Nepalese Engineers (ASNEngr), America Nepal Medical Foundation (ANMF), and Computer Association of Nepal-USA (CAN-USA)--a joint initiative on Earthquake Preparedness and Disaster Relief in Nepal, of which this position/concept paper is a product, was launched to help understand the current status of earthquake preparedness in Nepal. This position paper describes the challenges that Nepal will face if and when another large-magnitude earthquake strikes like the devastating January 16, 1934 Nepal-Bihar earthquake. The paper also provides a list of recommendations to be considered to minimize the loss of life and property, especially in the densely populated Kathmandu valley. The document is peer-reviewed by a group of individuals having expertise in the related areas.