10 Most Common Reasons for Emergency Room Visits

According to data from the Centers for Disease Control and Prevention, US emergency departments handle over 130 million visits per year. The conditions that drive the majority of those visits are consistent across years and demographics. Understanding the most common reasons helps people make better decisions about when ER care is necessary versus when an urgent care clinic or a call to a primary care physician is the appropriate first step.

1. Chest Pain and Cardiac Symptoms

Chest pain is the second most common reason for ER visits in the United States and is consistently among the presentations that require the fastest evaluation. While many presentations of chest pain have non-cardiac causes — musculoskeletal pain, acid reflux, anxiety-related symptoms — the potential for a cardiac event (heart attack, unstable angina, aortic dissection) makes chest pain a condition that warrants emergency evaluation rather than a wait-and-see approach.

The ER evaluation of chest pain typically includes an electrocardiogram (EKG), cardiac enzyme blood tests, and in some cases imaging. Most patients presenting with chest pain will not be found to have an active cardiac event, but the evaluation is warranted because the consequences of missing one are severe.

2. Abdominal Pain

Abdominal pain is consistently among the top reasons for ER visits across all age groups. The range of conditions it can represent — from minor, self-resolving digestive issues to appendicitis, bowel obstruction, gallbladder disease, kidney stones, ovarian torsion, ectopic pregnancy, and aortic aneurysm — requires evaluation to determine cause and severity.

The ER workup for abdominal pain typically includes a history and physical examination, laboratory studies, and often abdominal imaging (ultrasound, CT scan, or both). The triage priority for abdominal pain is determined by associated symptoms: fever, vomiting, inability to keep fluids down, severe pain that came on suddenly, or pain in a high-risk anatomic location (lower right quadrant for appendix, lower abdomen in a woman of childbearing age) all increase urgency.

3. Unintentional Injuries

Injuries — falls, motor vehicle accidents, cuts, burns, sports injuries — are among the most frequent causes of ER visits, particularly in children and adults over 65. Falls are the leading cause of injury-related ER visits in older adults and the leading cause of injury-related death in adults over 75.

The ER evaluation of injuries depends on the mechanism and suspected severity. Injuries that warrant immediate ER evaluation (rather than urgent care) include: suspected fractures of the spine, pelvis, or femur; injuries with signs of arterial bleeding; head injuries with loss of consciousness or worsening neurological symptoms; and penetrating injuries to the torso.

4. Shortness of Breath and Breathing Problems

Difficulty breathing is consistently in the top reasons for ER visits because its causes range from manageable (anxiety, mild asthma exacerbation) to immediately life-threatening (pulmonary embolism, heart failure, severe pneumonia, anaphylaxis). The ER evaluation includes oxygen saturation measurement, respiratory examination, chest X-ray, and often additional testing depending on the suspected cause.

Breathing difficulty that warrants immediate emergency evaluation includes: inability to complete a full sentence without stopping to breathe, labored breathing with visible effort, bluish discoloration of the lips or fingertips, sudden onset after a potential allergic trigger, and any breathing difficulty in an infant or very young child.

5. Fever and Infection Symptoms

High fever — particularly in the very young, very old, or immunocompromised — is a common reason for ER visits. The concern in these populations is that fever may indicate a serious bacterial infection (pneumonia, urinary tract infection that has spread to the kidneys, meningitis, sepsis) that requires prompt diagnosis and treatment.

Fever that warrants ER evaluation rather than a call to a primary care physician includes: fever in an infant under three months old; fever above 104°F (40°C) that is not responding to antipyretics; fever accompanied by stiff neck, severe headache, sensitivity to light, or rash; and fever in a person who is immunocompromised, recently underwent surgery, or has a central venous catheter.

6. Head and Neck Injuries

Head injuries are among the most common injury-related reasons for ER visits, particularly in children under 5 and adults over 65. The concern is the possibility of intracranial injury — bleeding inside the skull — that may not be immediately apparent from the external presentation. CT imaging of the head is frequently used to evaluate significant head injuries.

Head injuries that warrant ER evaluation include: loss of consciousness (even briefly), worsening headache following a head injury, confusion or disorientation, vomiting after a head injury, unequal pupils, or any head injury in a person on blood thinners.

7. Stroke Symptoms

Stroke — the sudden interruption of blood flow to part of the brain — is one of the most time-sensitive conditions treated in emergency medicine. The FAST acronym (Face drooping, Arm weakness, Speech difficulty, Time to call emergency services) identifies the most common acute stroke symptoms. The treatment window for the most effective interventions is narrow — within hours of symptom onset — making immediate ER evaluation essential.

Any sudden-onset neurological symptom (weakness on one side of the body, sudden vision changes, sudden severe headache unlike any previous headache, sudden balance or coordination problems) warrants emergency evaluation.

8. Back Pain

Musculoskeletal back pain is one of the most common reasons for all types of medical visits, including the ER. Most acute back pain — a strained muscle or ligament — is benign and self-limiting, and ER evaluation often finds no specific structural cause. However, back pain is also the presentation of several conditions that require urgent diagnosis: kidney stones, spinal epidural abscess, vertebral fracture, and aortic aneurysm.

Back pain that warrants ER evaluation rather than a scheduled appointment includes: pain accompanied by fever, pain accompanied by urinary symptoms, sudden severe pain in an older adult (especially with osteoporosis), pain radiating down the leg with new leg weakness or bladder or bowel changes, and pain following significant trauma.

9. Urinary Tract Problems

Urinary tract conditions — painful urination, difficulty urinating, blood in the urine, flank pain from kidney stones — are common reasons for ER visits, particularly in women and in older adults. Kidney stones, which cause severe flank or lower abdominal pain that often comes in waves, are frequently initially misidentified by patients as back pain or abdominal pain.

Urinary symptoms that warrant ER evaluation include: inability to urinate; blood in the urine accompanied by fever or flank pain (suggesting a kidney stone that may require intervention or a kidney infection); and any urinary symptom in a person with a single kidney, a kidney transplant, or known kidney disease.

10. Mental Health and Substance Use Crises

Mental health emergencies — acute psychiatric crises, suicidal ideation with a plan or intent, severe agitation, overdose — account for a significant and growing percentage of ER visits in the United States. Emergency departments have become the de facto crisis care setting for many people in mental health emergencies, partly because of limited availability of other options.

Emergency evaluation is warranted for: active suicidal ideation with intent or plan; overdose or suspected poisoning; severe agitation that poses a risk of harm to self or others; and acute psychosis (loss of contact with reality, hallucinations, or delusions that have emerged suddenly or escalated significantly).

Understanding what takes people to the emergency room most often is useful for recognizing when emergency care is genuinely needed versus when an urgent care clinic or a same-day primary care appointment is more appropriate. Emergency rooms are an essential resource — and their overuse for non-emergency conditions reduces availability for the people who need them most urgently.