Emergency departments must answer the call of all patients at any time of the day. However, as the typical day progresses, bottlenecks may develop in the process of delivering care. Patient safety can be compromised. This article summarizes key current issues in emergency department safety. Factors that affect patient safety are numerous; however, the best intervention may be reducing patient length of stay. Increasing number of patients and aging populations add to the risk of injury when the patient's length of stay exceeds the accommodations and capabilities of traditional short-stay acute-care oriented emergency facilities.