Grey’s Anatomy Turns 20: The Best Episodes That Shaped the Medical Drama Into a Classic

Season 1, Episode 9: “Who’s Zoomin’ Who?”

Honorable mention: “A Hard Day’s Night” (Episode 1)

There’s no better way to be introduced to Grey’s Anatomy than the first episode. The inaugural hour is one of the best TV pilots — setting up the tumultuous love story between Meredith Grey and Derek “McDreamy” Shepherd (easily one for the pop culture history books) while teeing up the intern class’ rocky medical careers and establishing the complicated hospital dynamics within Seattle Grace. But we’re zeroing in on the final episode of Season 1, which marks the arrival of Addison Montgomery-Shepherd (Kate Walsh). With one snarky remark (“You must be the woman who’s been screwing my husband”), Addison derails Meredith and Derek’s blossoming romance, propelling Grey’s into another creative stratosphere.

Season 2, Episode 5: “Bring the Pain”

Honorable mention: “It’s the End of the World” (Episode 16)

Grey’s has no shortage of classic lines — it’s what you get when you combine strong writing with impeccable acting. This episode, written by Rhimes, produced one of Meredith’s most widely quoted pieces of dialogue. Uncertain about her romantic future with Derek, who’s mulling reuniting with Addison or signing divorce papers, Meredith makes a final emotional plea to save their relationship, ending her last stand with the impactful declaration, “Pick me. Choose me. Love me.” Meredith doesn’t get the outcome she wants, leading to a period of emotional turmoil.

Season 3, Episode 17: “Some Kind of Miracle”

The show is at its best when large-scale emergency events take center stage. This one takes the cake for its long-term impact on the characters involved. Two episodes earlier, Meredith drowns after accidentally being pushed into the frigid waters by a victim, losing consciousness and getting revived after flatlining. The episode is the first time we see Meredith grappling with death and the afterlife when she interacts with pivotal characters who have since passed, from Denny Duquette (Jeffrey Dean Morgan) to bomb squad member Dylan Young (Kyle Chandler). When Meredith’s mother, Ellis (Kate Burton), who is suffering from Alzheimer’s, gives her permission to return to the living, it’s a poignant, bittersweet moment — reminding us just how fragile life is. As Meredith wakes up, much to the relief of Derek and Cristina, her mother takes her last breath.

Season 4, Episode 1: “A Change Is Gonna Come”

Meredith, Cristina, Izzie, and Alex start their residencies, now responsible for mentoring the new intern class — which includes Lexie Grey (Chyler Leigh), whom Meredith discovers is her half-sister — while George is forced to repeat his internship after failing the exam. The Season 4 premiere has all the ingredients that make it a classic Grey’s episode: unexpected curveballs, uncomfortable power struggles (Bailey vs. Callie as chief resident), oddball medical cases (remember the deer?), and pseudo love triangles (don’t forget Derek flirted with Lexie, aka “the girl from the bar”).

Season 5, Episode 24: “Now or Never”

Perhaps the most devastating finale of Grey‘s, the season closes with a John Doe — whose face is so battered he’s unrecognizable — admitted into the ER with life-threatening injuries after getting hit by a bus. It’s only in the final minutes of the episode that John Doe is able to communicate with Meredith, faintly writing “007” on her palm — George’s nickname from Season 1. The terror and devastation on Meredith’s face is gut-wrenching once she realizes that John Doe is George, and the urgency to save him becomes priority No. 1. Not knowing George’s fate and Izzie’s, who flatlines after undergoing surgery for cancer, was one of Grey’s most shocking cliffhangers.

Season 6, Episode 6: “I Saw What I Saw”

Honorable mentions: “Sanctuary” (Episode 23), “Death and All His Friends” (Episode 24)

The episode doesn’t rewrite the medical drama script, but it does set the bar high. Revolving around the death of a patient, residents from both Seattle Grace and Mercy West — amid a contentious hospital merger introduced the episode before — are interrogated about the case until the doctor responsible is identified and as a result of their malfeasance, fired. It’s a tense-fueled, twist-filled hour that illustrates the stakes that these residents endure — one split-second decision often meaning life or death for their patients. When April (Sarah Drew) is let go for her mistake, it underscores that there are real repercussions for their errors.

Season 7, Episode 18: “Song Beneath the Song”

OK, hear us out. When the musical episode originally aired in 2011, the reactions were understandably mixed. How can you realistically create a circumstance where the non musically-inclined doctors — and by extension, some of the actors — randomly break out into song? Out of left field even for Grey’s (and the show does some silly things), the controversial hour has become an episode that some fans have grown to appreciate over time. Some of the performed numbers are key to Grey’s lore, from The Fray’s “How to Save a Life” to Snow Patrol’s “Chasing Cars,” and showcases the cast’s various vocal skill sets. Rhimes, the episode’s credited writer, figured out a way to introduce the musical element by leaning into the whimsy, centering the plot around Callie’s (Sara Ramirez) out-of-body experience as she watches her own surgery.

Season 8, Episode 24: “Flight”

Heartbreak and pain are likely the first words that come to mind when you think of Grey’s, especially when it’s time to close out a season. Considered one of the series’ most gut-wrenching TV finales, the plane crash — which happens after a medical flight to Boise, Idaho, suffers mechanical failure and goes down in the woods — arguably changed the course of the show forever. The accident claims the lives of two fan favorites, Lexie and Mark Sloan (Eric Dane), and forces the amputation of one of Arizona Robbins’ (Jessica Capshaw) legs. The repercussions of the crash would have long-lasting effects on the show, as it took on a darker tone in subsequent seasons, and had wide-ranging consequences for the characters.

Season 9, Episode 2: “Remember the Time”

The beginning of Season 9 was spent dealing with the aftermath of the fatal plane crash. And it’s this episode where the viewers, along with the doctors, finally let Mark (aka “McSteamy”) — who, at one point, looked like he would survive his injuries — go to the afterlife. A new season also means another intern class, which this season included characters like Jo Wilson (Camilla Luddington). Despite Meredith, Derek, Cristina, and Arizona reeling from the trauma they went through, lives still need to be saved and medicine to be taught.

Season 10, Episode 24: “Fear (of the Unknown)”

After playing Cristina for nearly a decade, Grey’s officially bid farewell to Sandra Oh in this perfect send-off of a beloved OG cast member. Meredith and Cristina’s friendship represented one of the greatest female bonds in modern TV history, from their impromptu “dance it out” parties to declarations that they’re each other’s “person.” As evidence that Cristina is the best friend we would all be so lucky to have in our corner, she urges Meredith to seek fulfillment by achieving her own path and reminds her not to forget her self-worth — and not to bury herself in romantic entanglements. “Don’t let what he wants eclipse what you need. He’s very dreamy, but he is not the sun. You are,” Cristina tells Meredith in their powerful final scene.

Season 11, Episode 21: “How to Save a Life”

One of the most shocking Grey’s exits comes in this late Season 11 episode, which marked the death of Derek Shepherd. After temporarily relocating to Washington, D.C., for a new job (and being absent much of the season), Derek finds himself the victim of a violent accident after his car is struck by a semi-truck. He is rushed to a nearby hospital — the ER headed by less capable doctors — with life-threatening injuries. Unable to communicate with the medical staff, who miss time-sensitive symptoms until it’s too late, Derek is declared brain-dead, and Meredith makes the impossible decision to turn off life support. In a heart-wrenching goodbye scene, Meredith promises Derek that she and their children will “be fine,” giving him permission to go.

Season 12, Episode 5: “Guess Who’s Coming to Dinner” 

The series’ 250th episode is a doozy. Meredith hosts a dinner party that starts off pleasant and quickly blows up as the truth behind Callie’s new girlfriend, Penny (Samantha Sloyan) — one of the doctors responsible for Derek’s death — comes to light. The episode does a spectacular job exploring everyone’s feelings about Derek’s death and individual grief journeys, incrementally building up the tension until the pressure cooker environment becomes too much to bear. When Meredith acknowledges Penny’s role in Derek’s death, you can feel her unrelenting pain once Amelia (Caterina Scorsone) confronts her about keeping Penny’s identity a secret, tearfully screaming at Owen (Kevin McKidd) to remove the younger Shepherd from her room.

Season 13, Episode 23: “True Colors”

Not shying away from difficult subject matter is a major reason Grey’s has continued to make an impact. In this episode, which explores domestic abuse, Jo comes face to face with her estranged abusive husband Paul Stadler (Glee‘s Matthew Morrison), a popular and successful surgeon. The timeliness of the hour, which aired in 2018 at the height of the #MeToo movement, wasn’t lost on Luddington at the time. “This storyline is about no longer feeling silent and about women finding the strength to use their voice to be heard, believed, and feel empowered,” she told The Hollywood Reporter. Don’t worry, Paul meets his karmic match, later succumbing to his injuries after a hit-and-run and a physical altercation with his fiancee.

Season 14, Episode 7: “Who Lives, Who Dies, Who Tells Your Story” 

Winning the prestigious Harper Avery Award is a rite of passage. In the world of Grey’s, it means you’ve reached the pinnacle of your medical career, earning praise and respect for your research and accomplishments. Despite going through tremendous loss, Meredith is named the recipient of the award for surgical innovation — with Jackson Avery (Jesse Williams) delivering a poignant speech on her behalf celebrating her resiliency and praising her on the ability to channel personal pain and loss to save lives. It’s a beautiful reminder of just how far Meredith has come since we first met her as a wide-eyed intern in the pilot.

Season 15, Episode 19: “Silent All These Years” 

If there’s one episode that highlights the best of Season 15, it’s this one — largely for one dialogue-less scene. The installment focuses mainly on Jo’s story. The episode reveals that Jo, who was abandoned by her birth mother at a fire station, was the product of a rape. When a patient comes into the hospital, a victim of domestic abuse and sexual assault, Jo takes great care in giving the woman — who sees her rapist in every male face — the support she herself didn’t receive. It’s the hallway scene, where female doctors, nurses, and staff line up the hospital walls, that is heartbreakingly powerful. As Jo’s patient is wheeled down to surgery, giving her a safety net, it is a crucial representation of women standing behind women.

Season 16, Episode 8: “My Shot”

Honorable mention: “Leave a Light On” (Episode 16)

In what would turn out to be Justin Chambers’ final onscreen appearance as Alex (he returns later in the season in voiceover to close out his story), the 300th episode puts Meredith’s medical career on the line after she commits insurance fraud to help a patient. The board seems intent on making Meredith a martyr and the irony is not lost when one of the board members ends up having played a hand in Derek’s death. When all hope seems lost, Alex recruits many of Meredith’s old patients, including her very first one, to speak up for Meredith.

Season 17, Episode 2: “The Center Won’t Hold”

Honorable mentions: “You’ll Never Walk Alone” (Episode 4), “Breathe” (Episode 10)

One of the big questions following the pandemic was how shows would address (or ignore) COVID-19. Grey’s embraced the pandemic storyline in Season 17, putting Meredith at the center of it. After experiencing COVID symptoms, Meredith slips into unconsciousness and is left on a ventilator as the others scramble to cure an illness they don’t have all the answers to yet. Still unconscious, Meredith is transported to a sunny beach in her COVID dream — a purgatory existing between life and death. It’s in the final moments of this episode where Meredith “sees” her late husband, Derek, for the first time since his death in Season 11. The reunion was much needed for the characters and for fans of the show, who may have felt their story lacked closure. During a heart-to-heart in a later episode, Derek gives Meredith the push to go back to the living, assuring her that she gave him “everything he needed” to accept death. Derek’s return also opened the door for other characters like George, Lexie, and Mark to pay Meredith a visit.

Season 18: Episode 3: “Hotter Than Hell” 

When Addison returns to Seattleto help lead the new crop of interns — and inevitably take part in a high-risk transplant surgery — it’s an opportunity for a reset of sorts. Once archrivals due to the whole Derek factor, time and distance have allowed Meredith and Addison the strength to let water under the bridge. When Addison summons Meredith’s help in the OR, their teamwork is so strong you wonder what could have been had they not been at each other’s throats. In a full-circle moment, Addison breaks down in the elevator, admitting to Meredith that she looks for Derek’s presence everywhere she turns. It’s a rare glimpse at the love Addison and Derek shared pre-Grey’s. 

Season 19, Episode 1: “Everything Has Changed”

Honorable mention: “Thunderstruck” (Episode 6)

Season 19 was a major turning point for Grey’s. Pompeo stepped back full-time as Meredith Grey, appearing in less than half the episodes while still remaining an executive producer and narrator. But before Meredith left Seattle to work on Alzheimer’s research for the Catherine Fox Foundation in Boston, the premiere episode reminded us of the series’ early glory days. Acting as the interim chief of surgery, Meredith welcomes new residents (the strongest group in years) as Grey Sloan seeks to re-establish its once storied residency program and restore its reputation. Remember the iconic speech Webber gives the interns in Season 1? It’s Meredith who’s delivering the same famous words. There are other parallels: Surgeon Nick Marsh (Scott Speedman) parrots Derek’s catchphrase (“It’s a beautiful day to save lives”) and the intern class is reminiscent of the bond Meredith, Cristina, Alex, Izzie, and George shared.

Season 20: Episode 10: “Burn It Down”

A shortened season due to the writers and actors strikes in 2023, the finale put a lot of characters’ fates in jeopardy — from Meredith’s decision to go rogue with her Alzheimer’s research to the firings of Teddy (Kim Raver), Owen, and Amelia to the interns standing in solidarity with Lucas (Niko Terho), who’s threatened with the possibility of redoing his residency year. It’s an action-packed season closer reminiscent of what Grey’s does best.