15 Saddest Grey’s Anatomy Episodes, Ranked

Grey’s Anatomy has a history of breaking fans’ hearts with sudden deaths and shocking moments. The show has put its main characters through a lot. Set in a hospital where life and death are just one surgery away, the show is filled with tear-jerking tragedies. Grey’s Anatomy has a track record of killing off its characters in a shocking fashion, leaving fans scarred for their lives.

Happiness is short-lived on Grey’s Anatomy, and that’s particularly true for Meredith Grey. She had a tough childhood, raised by a workaholic mother who had no love for the man she married. Throughout the 20 seasons of the show, she has found and married her one true love, had a family, and met her sister, but her happily-ever-after always had a twist in the end. From fan-favorite character exits to selfless sacrifices, the saddest moments in the show are truly heartbreaking.

This article was updated on January 3, 2025, by Christopher Raley: Grey’s Anatomy made a household name for itself as a medical drama that showed doctors dealing with an array of professional and personal dilemmas. The show also proved it could create some of the saddest episodes on nighttime TV. Five more sad episodes have been added to this list, and it has been updated to conform to CBRs current publishing standards.

15. The Sound of Silence Shows Meredith Recovering From an Attack

It Also Highlights the Need For Forgiveness

Denzel Washington directed the mid-season premiere of the Grey’s Anatomy Season 12, “The Sound of Silence.” On their way to work, Meredith, Maggie, and Alex are stuck in traffic because of a major accident. When they get to the hospital, they start working on patients from the accident right away. At one point, Meredith is alone with a patient who attacks her as a result of post-seizure hyper-aggression in a Grey‘s scene that fans don’t want to see again.

This leaves Meredith unconscious on the floor. When she wakes up, she discovers that she can’t speak (her jaw is broken) and she can’t hear. The assault was only part of why this episode was so devastating. When her kids see her condition, they run out of the room. The man who attacked her wants to apologize, but she refuses to see him. In the end, Dr. Webber gives her a heartfelt speech about the need for forgiveness, but it’s sad to watch her go through all the pain to get to this point, cementing its place as one of Grey’s Anatomy‘s most crushing episodes.

14. Helplessly Hoping Delivers a Major Character Death

Andrew DeLuca is Stabbed Trying To Stop a Human Trafficker

Andrew DeLuca (Giacomo Gianniotti) came into the cast of Grey’s Anatomy in Season 11 as a surgical intern. He worked hard, had a relationship with Meredith, then didn’t. But they ended amicably in a way that endeared him to fans. His mental health struggle also created a lot of sympathy for the character as he fought to overcome his bipolar disorder.

By the time season 17 rolled around, Andrew was an attending surgeon and doing well. When things are going well on Grey’s Anatomy fans know something bad is about to happen to undercut it all. But it still shocked and saddened fans when Andrew was stabbed, aiding in the arrest of a human trafficker. He recovered at the hospital, which gave viewers just enough hope to be heartbroken when he died in the middle of a second surgery.

13. Drowning on Dry Land Had Fans Terrified for Meredith

This Is One of the Saddest Episodes Despite Her Survival

Early on in the show, Meredith and Derek’s relationship is not the best. Meredith loves him but knows that he’s married, while Derek loves her but feels he should try to patch things up with his wife. By the time fans get to season 3, the timeline of Meredith and Derek’s relationship has already gone through some significant ups and downs.

When Meredith falls off a ferry into the icy water in “Drowning on Dry Land,” she and Derek have been “on” again. Her near-death experience coupled with the fact that her mom dies in the same episode brings about an emotional landslide for Meredith. The show pulled a fast one on fans, setting up Derek saving Meredith as being super romantic, but snatched it away, making this episode a bitter one.

12. Miranda Loses Her Mom to COVID

Fight the Power Is Season 17’s Most Powerful COVID Arc

As a medical drama, Grey’s Anatomy found itself in a position of having real-life events provide it its storylines. Of course, one could argue that storms, attacks, plane crashes, and car wrecks are real too. However, the COVID-19 pandemic was in full force in early 2020. This gave Grey’s Anatomy writers the chance to craft episodes based on the pandemic which was still in full swing when the season began airing in November 2020.

Meredith’s COVID dream sequence might have been one of the saddest moments to come from that season, had it not been for Miranda losing her mother to the disease. When an outbreak hits the assisted living home where her mother was, they take her to the hospital with an advanced infection. She was already suffering from Alzheimer’s, but Miranda’s final moments with her mom were heart-breaking, not the least because many people at that time were worrying about their loved ones as well.

11. Death and All His Friends Portrays a Hospital Shooting

This Two-Parter Was the Shocking Season 6 Finale

When a shooter gets into Grey Sloan, the doctors are in for a tragic experience that results in another character’s death and injuries to others. Grey‘s Reed Adamson dies at the hands of the hospital shooter, Gary Clark. Meanwhile, doctors and nurses work frantically trying to save the lives of the injured while in danger themselves.

Teddy and Owen try to get a patient to the ICU. Derek is lying bleeding on the floor and Christina tries to stop Meredith from rushing out to save him. The episode plays out like a horrifying game of cat and mouse. In the end, the gunman has it out for Derek and Christina has to fake his death during surgery to convince the gunman to leave. After all is said and done, the episode is relentlessly devastating.

10. Derek Shepherd Dies in “How to Save a Life”

Just When the Couple Finally Settles Their Differences

After everything Meredith Grey has gone through to be with Derek Shepherd, her husband died due to the on-call surgeons’ mistakes in Grey’s Anatomy Season 11, Episode 21. The entire episode was told through Derek’s point of view. After taking the job in DC, Derek realized how it was damaging their marriage. He wanted to come back here to be with Meredith and the kids. However, he had to go back to DC one last time. He arrived at the scene of a car crash.

After treating the victims, he was involved in another crash. Sadly, the hospital that received him had poorly trained staff that mistreated him and caused his death. It’s not the fact that Meredith’s world collapsed once again that hurts viewers the most, but the fact that Derek could have survived his injuries if he had been taken to Grey Sloan Memorial Hospital instead. Derek, as a teacher and a surgeon who saved so many lives, died due to his surgeon’s ignorance and burned this episode into the minds of Grey’s fans everywhere.

9. Lexie Grey Died In Season 8, Episode 24, “Flight”

This Loss Hurt Yet Again Rocks Meredith’s Life

It’s been a long time since the plane crash at the end of Season 8, but many Grey’s fans still haven’t recovered from it. Lexie Grey grew to become one of the fan-favorite characters on Grey’s Anatomy. She’s smart, funny and kind. Lexie was a young doctor with a promising future, being one of the brightest in her class.

It was truly sad to lose her on the show, especially when her relationship with Mark Sloan was still unresolved. The two loved each other, but they spent most of the show with other people, only to learn that all they wanted was each other. The two were getting back together when the plane crash put their story to an end. Lexie and Mark were finally together, but their happily-ever-after ended on a bitter note.

8. April and Jackson’s Child Died from a Rare Birth Difficulty

The Death Leaves April Questioning Herself

April Kapner has always been a religious person, who believes that everything happens for a reason. But sadly, sometimes, bad things happen to good people for no reason at all. April and Jackson’s first baby had type II osteogenesis imperfecta, meaning that the baby’s bones were breaking in her uterus.

She went through labor and held her son with Jackson until he passed naturally in her arms. The episode is heartbreaking, especially when baby Samuel squeezed her finger before he died. Samuel’s death cracked a hole in April and Jackson’s marriage. This even made April start questioning her faith in God.

7. Burk Left Cristina at the Altar

He Thought She Needed to Be Free

Grey’s Anatomy Season 3, Episode 25, “Didn’t We Almost Have It All?” shows moments fans will never forget. Preston Burk exited the show on his wedding day with Cristina Yang. Their relationship wasn’t perfect, but Cristina stood by Burk through thick and thin. They are both brilliant surgeons who want to be at the top of their field. Burk was Cristina’s mentor, and he truly admired her and understood her.

However, as he waited for Cristina to join him at the altar, he realized that he never loved her, because if he did, he would have respected who she was instead of trying to mold her into who he wanted her to be. No one died in the episode, but Cristina was set free after sacrificing so much for Burk. She would have continued sacrificing the vision she had for herself if Burk hadn’t left her at the altar. The episode is about heartbreak and freedom in equal measure.

6. Denny Duquette Dies a Painful Death in “Losing My Religion”

Izzy Tried to Save Him But Couldn’t

Tragedies happen when fans least expect. Denny Duquette’s death marks the beginning of a long list of brutal deaths in Grey’s Anatomy, making Season 2, Episode 27 an episode that fans won’t be able to forget. Izzie put her medical license at risk to steal a heart for Denny so that he could live. She went to great lengths and would actually lose her job for Denny, but even then, her fiancé died suddenly while she was on her way to him. She put on a fancy dress to see him only to find his body cold on the hospital bed. It’s not only the death that’s heartbreaking but also the fact that Denny died all alone.

Denny’s death had a profound impact on Izzie and the show itself. He frequently showed up as an allusion to death. When Izzie had cancer, Denny was the one who made her see that she was critically ill, and when Meredith was fighting for her life, Denny again showed up as a ghost. The reappearance of the character made his death less painful over time. However, it still doesn’t minimize the initial impact it had on fans.

5. George Was John Doe

This Character’s Death Left a Mark on the Show

Grey’s Anatomy Season 6, Episode 1, “Good Mourning” opens with George’s death. The episode comes after the heartbreaking revelation near the end of Season 5 when Meredith figured out that George was John Doe, the faceless hero they had been trying to save after he saved a girl from being hit by a bus. Despite trying everything to save him, George died on the operation table while Izzie was collapsing.

The two briefly met in the limbo state. While Izzie was able to find her way back to life, George didn’t. The entire hospital started mourning after his death, and Callie had to decide whether to donate George’s organs. The episode left many fans in tears. It’s particularly shocking since George is the first main Grey’s Anatomy character to be killed off the show. His death left many viewers in shock since the character was one of the kindest people on Grey’s Anatomy.

4. Alex Karvev Left Jo for Izzie

Alex’s Betrayal Was Heartbreaking

In Grey’s Anatomy Season 16, Episode 16, “Leave A Light On,” the long-time character, Alex Karvev, left the show. Unlike the brutal deaths that fans have gotten used to, his departure is heartbreaking in a quiet way. Sometimes it can be just as heartbreaking to see a couple split up as to see a character die.

Karvev left the show without saying goodbye to anyone. He left his wife, Jo, with a letter, informing her that he wanted to be with Izzie for the sake of their kids. However, this decision came as completely unfair and heartbreaking for Jo, given that her world has collapsed with her husband leaving her without even saying goodbye in person.

3. Adele Passed Away at Bailey’s Wedding

Richard Mourned Her Death

Season 9, Episode 10, “Things We Said Today” sees the beginning of one Grey’s ​​​​​​marriage and the end of another. Richard Webber’s marriage to Adele wasn’t a perfect one. He had made many mistakes during the many years they were married, but Adele was truly the one person he wanted as a wife.

Richard was finally making amends to Adele when she passed away. Despite Bailey postponing her wedding to save Adele, she passed away from a heart attack shortly after. Richard was mourning her death while being reminded of the day they got married, making it truly soul-crushing.

2, Henry Died Suddenly in Season 8, Episode 10

One of the Show’s Best Characters Died

Teddy Altman initially married Henry to help him with his insurance. Their marriage wasn’t real in the beginning, and Teddy, after spending so many years in love with Owen Hunt, deserved someone who would treat her better. Henry fell in love with Teddy first, knowing how kind she was. After many bad dates turned into wonderful dates with Henry, Teddy found herself in love with him as well.

The two were planning on a future together and fighting about the idea of Henry pursuing a medical career when Henry needed heart surgery. Teddy got called into surgery and wasn’t aware of the fact that her husband had died on the operation table. Owen, as the Chief of Surgery, had to put the patient first and lie to Teddy about Henry’s death. The episode feels incredibly sad since Teddy thought her husband survived the whole time she was operating on someone else only to learn that it was a lie.

1. Bonnie Died for a Stranger

“Into You Like a Train” Hit Hard as Hard as the Title Suggests

Grey’s Season 2, Episode 6 has one of the most heartbreaking patient deaths. Two patients were impaled on the same piece of metal tube in a train accident. Bonnie was a really sweet and funny person who was about to get married. She had her whole life before her, but Bonnie sacrificed her life so that a stranger could live.

Tom’s condition was far better than Bonnie’s. When it was clear that saving them both wasn’t an option, the doctors notified them that Bonnie had to die. Instead of reacting in any extreme way, Bonnie was very calm in the face of her own mortality. She remained a ray of sunshine until the end, saving a stranger’s life with her own.