The Rwandan Genocide started on April 6, 1994 as the Hutu led Interahamwe began to slaughter the Tutsi population. Though Rusesabagina was of mixed heritage – his father was Hutu and his mother Tutsi – he was relatively safe from the Interahamwe due to his position and business connections with important Hutu military leaders. These connections notwithstanding, his wife Tatiana was a Tutsi, and their children were considered mixed, so he could not escape the war zone with his family without outside help. However, no foreign aid came from the United Nations or its more powerful Western member states until after over 800,000 Rwandans had been murdered.
When the violence broke out, Rusesabagina brought his family to the Hôtel des Mille Collines for safety. As other managers departed, Rusesabagina phoned the hotel's corporate owners, Sabena, and secured a letter appointing him the acting general manager of the Mille Collines. Despite some difficulty in getting the staff to accept his authority, he was able to use his position to shelter orphans and other refugees who came to the hotel. His neighbours had moved into his house for safety, though Rusesabagina did not even own a gun. For protection against bullets and grenades they put mattresses against the windows. He described the hardships they faced, which included having to drink the water from the hotel's swimming pool.
When a murderous Hutu militia threatened to enter the Mille Collines, Rusesabagina ensured that his wife and children fled safely in a truck past the militia's roadblocks. The truck set out for Kigali airport so they could flee to another country. He himself remained in the hotel because the refugees needed him. Rusesabagina and his wife discussed this decision for hours, because he had promised her he would never leave her in this situation. Rusesabagina wanted to stay, fearing the remaining refugees would be killed and feeling that he would never be able to forgive himself.
The truck was forced to return to the hotel, never having reached the airport. Everybody in the truck, including Tatiana and the children, had been beaten. Tatiana was a specific target for the beatings because she was the wife of the manager of the Mille Collines; the Hutu militia knew she and her children were in the truck owing to radio messages sent out by presenter Georges Ruggiu. Ruggiu was an Italian-Belgian who was part of the radio station conspiracy to incite ethnic tension and encourage the Hutu population to kill all the Tutsis. Ruggiu called Rusesabagina's family "cockroaches who were fleeing, but would return later to kill all the Hutus".
Tatiana's mother, and 4 nieces and nephews, died in the genocide. Her brother and sister-in-law are missing. Her father paid to be executed so he would not die a more painful death:
?We all knew we would die, no question. The only question was how. Would they chop us in pieces? With their machetes they would cut your left hand off. Then they would disappear and reappear a few hours later to cut off your right hand. A little later they would return for your left leg etc. They went on till you died. They wanted to make you suffer as long as possible. There was one alternative: you could pay soldiers so they would just shoot you. That's what her [Tatiana's] father did.—Paul Rusesabagina in Humo, nr. 3365, March 1, 2005
The Interhamwe left over 1 million corpses behind. Tutsi rebels pushed the Hutus into the Congo in July 1994, after over half of the Tutsis in Rwanda had been killed. Many children became orphaned and even more were killed after the Interhamwe attempted to wipe out the next generation of Tutsis. Rusesabagina took orphans from the camp behind Tutsi rebel lines with him to Tanzania, to keep them safe and away from Rwanda.
Rusesabagina, his wife and children, and the refugees eventually managed to escape to Tanzania, thanks to the Rwandan Patriotic Front. After staying in Rwanda for two more years, Rusesabagina applied for asylum in Belgium and moved to Brussels in 1996 after receiving credible threats on his life.
Rusesabagina received the US Presidential Medal of Freedom on November 9, 2005 from President George W. Bush.