This clinical review article examines the patient satisfaction literature for the past 20 years. This literature is summarized for qualitative themes and general trends. Intended for the practicing clinician, these themes are then applied to the emergency department (ED) milieu. According to the Agency for Healthcare Research and Quality, the ED is the point of entry for more than half of all patients admitted to the hospital in the United States. Indeed, the ED is the "front door" to the hospital. According to Press Ganey, satisfaction with ED care is at an all-time low. A review of the literature revealed 5 major elements of the ED experience that correlate with patient satisfaction: timeliness of care, empathy, technical competence, information dispensation, and pain management. The literature supporting these 5 elements is summarized and applications to the ED setting are suggested. Other minor correlates with patient satisfaction are also presented.