The International Nuclear Emergency Exercise (INEX) series, organised under the OECD Nuclear Energy Agency (NEA) Working Party on Nuclear Emergency Matters (WPNEM), has proven successful in testing, investigating and improving national and international response arrangements for nuclear accidents and radiological emergencies. Early INEX exercises focused on the national and international aspects of early phase management of nuclear power plant emergencies. Starting with INEX-3 (2005-2006), the international community began looking at issues concerning longer-term consequence management. In 2008, the WPNEM started preparing the INEX-4 series, which was conducted in 2010-2011 and addressed consequence management and transition to recovery in response to malicious acts involving the release of radioactive materials in an urban setting. The goal of INEX-4 was to provide a basis for enhancing emergency management through the exchange of exercise experiences from participating countries and the identification of good practices and common issues. This summary report provides general outcomes based on country responses to the INEX-4 evaluation questionnaire and suggests areas of focus for future consideration.