This literature review was written as part of a pilot study into staff perceptions of inappropriate attendance at accident and emergency (A&E) departments. The pilot study was carried out in the final year of the BSc Nursing Studies course at Birmingham Polytechnic. The literature under review looks at various aspects of inappropriate attendance at A&E, including what actually constitutes inappropriate attendance, who is responsible for misuse of A&E and why A&E is so often abused. Suggestions are offered that the role of A&E is more diverse than simply a receiving station for sudden injury or illness and that there are quite pertinent reasons why people choose to attend A&E rather than their own GP's surgery. The review covers quite a span of years, the oldest piece of literature under review dating back to 1849. Some 143 years show that indeed this particular problem is not necessarily a modern one but one that has its origins in another century.