Background &amp; aims <p>Organizational climate is recognized as a key factor in enhancing performance and retaining the workforce. Retaining operational staff in emergency medical centers is vital for improving service quality and reducing the costs associated with job turnover. This study aimed to investigate the relationship between organizational climate and Employee retention tendency of operational staff of the Accident and Emergency Medical Center of Mazandaran University of Medical Sciences.</p> Materials &amp; methods <p>This descriptive-correlational study was conducted on 210 operational staff members of the Mazandaran Emergency Medical Center, selected through stratified sampling from 30 bases. Data were collected using a demographic and occupational characteristics checklist, an organizational climate questionnaire, and an employee retention tendency questionnaire. Data analysis was performed in SPSS version 26 using statistical tests including the independent t-test, analysis of variance, and Pearson correlation coefficient.</p> Results <p>The mean scores for organizational climate (113.12 ± 17.76) and Employee retention tendency (47.27 ± 12.55) were at a desirable level. A statistically moderate correlation was found between organizational climate and employee retention tendency (<i>p</i> &lt; 0.001; <i>r</i> = 0.42). A significant relationship was observed between Employee retention tendency and employment status in administrative departments (<i>p</i> = 0.031), non-smoking (<i>p</i> = 0.004), and favorable economic status (<i>p</i> = 0.001). Furthermore, organizational climate was significantly associated with marital status (<i>p</i> = 0.044).</p> Conclusion <p>A favorable organizational climate plays a crucial role in enhancing the retention tendency of emergency medical operational staff. Therefore, healthcare organizations are recommended to implement strategies that improve the organizational climate and, in turn, strengthen human resource retention.</p>