Based on the issue of life safety and immediate needs of emergency medical services provided by hospitals after strong earthquakes, this paper aims to introduce a research programme on assessment and improvement strategies for a typical configuration of sprinkler piping systems in hospitals. The study involved component tests and subsystem tests. Cyclic loading tests were conducted to investigate the inelastic behaviour of components including concrete anchorages, screwed fittings of small-bore pipes and couplings. Parts of a horizontal piping system of a seismic damaged sprinkler piping system were tested using shaking table tests. Furthermore, horizontal piping subsystems with seismic resistant devices such as braces, flexible pipes and couplings were also tested. The test results showed that the main cause of damage was the poor capacity of a screwed fitting of the small-bore tee branch. The optimum improvement strategy to achieve a higher nonstructural performance level for the horizontal piping subsystem is to strengthen the main pipe with braces and decrease moment demands on the tee branch by the use of flexible pipes. The hysteresis loops and failure modes of components were further discussed and will be used to conduct numerical analysis of sprinkler piping systems in future studies.