When waiting times in accident and emergency (A&E) departments become too long, some patients leave the department before seeing a doctor. This study was designed to investigate the characteristics and outcome of this group of patients in one A&E department. We identified all patients who left the department without seeing a doctor on 12 randomly selected days in October and November 1997. These patients were contacted by post and non-responders followed up by telephone. During the study period 3097 patients registered for treatment, and of these 102 (3.26%) left before being seen. Of these 102 patients, 77 were contacted. The duration of their symptoms was less than 24 hours in 56 patients (73%). Their mean waiting time was 2.44 hours. Of the patients reviewed, 45 (58%) sought medical attention afterwards and one required hospital admission. The majority of patients were satisfied by the explanation given for the delay in seeing a doctor. This limited study suggests that patients are able themselves to gauge the severity of their symptoms and safely defer medical consultation.