Acute Stress Reactions (ASR) of local governments’ employees in the areas affected by the Great East Japan Earthquake was investigated. A questionnaire survey was conducted with the employees of two local governments along the coast and one local government inland in Miyagi Prefecture where the damage was less severe. Questionnaires (975) were distributed and 637 responses were collected (response rate = 65.3%). The results indicated that many participants complained of dissociative disorders and sleep disorders, but not often of physical symptoms, which is suggestive of the risk for PTSD and depression. When ASR scores were compared between the two areas, scores of employees in coastal areas were significantly higher, indicative of more stress, compared to those in inland areas, which confirmed a dose-response relationship with stress. Though ASR scores were determined by disaster experience as shown in previous studies, it was considered necessary to develop mental health care plans for different areas according to disaster conditions, because the determinants of ASR were different from inland and coastal areas.