The study objective was to determine if Emergency Department (ED) patients experience fewer breaches of privacy and confidentiality in a larger, renovated ED compared to a similar patient population before renovation. We surveyed a convenience sample of patients regarding their privacy and confidentiality at the conclusion of their ED stay. In the post-renovation ED, 14% of patients overheard conversations about themselves or other patients, compared to 36% of patients in the ED before renovation. This was likely a result of both an increase in the department size (564 square feet per treatment space post-renovation vs. 375 square feet per treatment space pre-renovation) and the elimination of rooms separated only by curtains. Issues of privacy and confidentiality should be taken into consideration in the design of new departments and those to be renovated.