The objective of this paper is to identify the failure modes of a typical sprinkler piping system used in hospitals and to propose appropriate improvement strategies for higher seismic performance. An actually damaged sprinkler piping system from a “designated as responsible” hospital during the Taiwan Jiashian earthquake in 2010 was duplicated for the shaking table tests. The same damage that occurred during the earthquake event was reproduced in the original configuration of the sprinkler piping. In addition, the modified configurations with the proposed seismic restraint devices were also tested. The test results show that the screwed fitting of the small-bore tee branch is the most vulnerable part of the tested piping system. The optimum improvement strategy is not only to strengthen the main pipe with braces but also to use flexible hose near the tee branch to decrease both the force and displacement demands on the screwed fittings.