Objectives: The purpose of this study is to understand the cognition of the initiation of diseases of North Korean refugees in South Korea.Methods: 9 North Korean refugees hospitalized in Oriental Neuropsychiatry of National Medical Center participated in the interview. The statements were analyzed by using the phenomenological re-search methodology and Giorgi's analytical method, in particular, was applied. Results: A total of 4 categories and 15 sub categories were derived from the participants' descriptions. North Korean refugees who thought their diseases have begun while living in North Korea coming to South Korea, have fire disease because of the strict social system, limitations imposed on their actions, and the violence of their husbands. And who thought during escaping from North Korea, have anxiety about being killed, found and transferred to North Korea. They also suffered from a sense of guilt to-wards their family who were left behind as well as from depression. Consequently, they thought their skeletal diseases have begun during this period. Who thought during their period in Korea, their dis-eases like fire disease and depression have been worsen because of unfamiliar circumstances and doc-tors who said their problems had been caused by psychiatric disorder. Nevertheless, they did their jobs, felt happy and had a will to be cured thingking possibilities of overcoming diseases. Conclusions: These results suggest that various factors during different periods in the life of North Korean refugees could have an effect on their present diseases.