Timely and effective emergency decision making (EDM) is the key to control the spread of disasters and reduce the casualties and property losses caused by emergencies. However, due to limited time and insufficient data, it is difficult for decision makers to provide accurate information about emergency incidents. Moreover, the EDM problems become complicated and unstructured requiring the deployment of advanced mathematical techniques to derive the most acceptable response. In this paper, we propose a new EDM approach by using picture fuzzy sets and axiomatic design technique for determining the optimal rescue plan to reduce the damages of emergencies. The contribution of this paper is to apply the picture fuzzy sets to handle the uncertainty and ambiguity of decision makers' assessments on emergency alternatives, apply the picture fuzzy hybrid averaging operator to aggregate decision makers' opinions into a group evaluation matrix and extend the axiomatic design technique to identify the best emergency solution for EDM. Finally, a real example is provided, and the result is compared with existing methods to demonstrate the feasibility and practicability of our proposed EDM approach.