This study focused on the on-call work record of social workers in a medical center in Northern Taiwan from 2012 to 2017. Statistics of case sources and problem types were collected, and the types of cases that led to on-call social workers' attendance, the necessity for such attendance, and social workers' roles and functions were analyzed. Being on call means that social workers carry an official cell phone in their off time in nonspecific occasions to respond to calls and handle the situations; they may be required to return to the office and work overtime when necessary. Of all the 525 nighttime or holiday on-call records from 2012 to 2017, most were from the emergency department (50%), followed by those from ward management (38%). Regarding the content of the calls, domestic violence and sexual assault ranked as the two most frequent causes of notice, accounting for 183 cases in total (approximately 34.9%). Moreover, among all the 525 notices, social workers attended work to handle 106 cases (20.2%) after judging the situations when they remained on call. After close examination of these 106 cases that required social workers' nighttime or holiday attendance, the authors identified the following four main types of situations: (a) the social workers' legal duty to accompany clients to receive medical examinations (64 cases); (b) safety evaluation or evaluation of placement and care need (22 cases), (c) clients with mental disorders or agitation (14 cases); and (d) other special cases (6 cases). Based on the aforementioned analysis, this study suggests that the attendance indicators for on-call social workers include the following situations: accompanying victims of sexual assault to visit the hospital and receive medical examinations for evidence collection; immediate evaluation and intervention is required when clients have placement needs or safety concerns; medical examinations for evidence collection is required when accompanying clients who are underage and visit the hospital alone; and supporting in other emergencies and special occasions (e.g., an excessive number of patients). Finally, a supportive environment must be built for medical social workers, which ensures they fulfill their roles and duties while preventing them from experiencing mental and physical exhaustion caused by on-call work.