Medellín is the second largest city of Colombia with more than 2 million inhabitants according to the latest census and with more than 240,000 public and private buildings. It is located on an intermediate seismic hazard area according to the seismic zonation of Colombia although no destructive earthquakes have occurred having as a consequence low seismic risk awareness among its inhabitants. Using the results of a fully probabilistic risk assessment of the city with a building by building resolution level and considering the dynamic soil response, average annual losses by sectors as well as casualties and other direct effects are obtained and aggregated at county level. Using the holistic evaluation module of the multi-hazard risk assessment CAPRA platform, EvHo, a comprehensive assessment that considered the social fragility and lack or resilience at county level is performed making use of a set of indicators with the objective of capturing the aggravating conditions of the initial physical impact. The urban seismic risk index,USRi, is obtained at county level which is useful to communicate risk to decision-makers and stakeholders besides making easy identifying potential zones that can be problematic in terms of several dimensions of the vulnerability. This case study is an example of how a multidisciplinary research on disaster risk reduction helps to show how risk analysis can be of high relevance for decision-making processes in disaster risk management.