During Lassa fever outbreaks, Treatment Centres (TCs) are critical for patient care and transmission control, yet their design remains underexplored. The study analyses three TC in Nigeria, using a reverse-engineering approach. Findings reveal major differences in capacity, zoning, and service integration, with implications for infection control, staff safety, and inclusivity. Recurring layout trends and critical gaps are identified. A set of spatial indicators is proposed and cross-case results are translated into design principles for LF centres. The work offers a framework for developing design standards to strengthen outbreak management, and highlights the need for adaptable facilities and future research to define indicators linking design with health outcomes and patient experience.