Today, following the problems caused by the rapid growth and transformation of cities; The preparation and implementation of urban plans is emphasized. Projects that in most cases could not succeed in the planned development of cities despite some positive aspects. The development plans of Tehran city, especially its five-year plans (as the study sample of this research) are not exempted from this rule. One of the measures that can be taken into consideration in the process of correcting the wrong trends and problems of urban development programs is the pathology of urban development plans and programs. Therefore, the main goal of this research is the pathology of the process Preparing, approving, implementing and monitoring the five-year plans of Tehran using the Comprehensive Pathology Model (FPSS). This research is in the category of applied research in terms of its purpose and descriptive-analytical research in terms of its nature. The required information has been collected by documentary-library and field methods (interview and questionnaire). In order to identify the damages, 15 experts were interviewed and the damages were evaluated (importance level) from the opinions of 43 other experts (in a selective and snowball method) in the form of a questionnaire. The results of the research show that in the first to third five-year development plans of the city of Tehran, 35 damages were common in the respective periods. In terms of drafting stages, the most damage was related to executive and supervisory areas, and in terms of content, content, functional and systemic damages were more than structural and process damages. Adopting non-elitist approaches in developing the program, developing systematic monitoring and supervision systems, and longitudinal and horizontal communication with documents and parallel programs are among the necessary suggestions to improve the system of medium-term development plans of Tehran.