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Aims and Objectives End-of-life (EOL) care is an essential yet often overlooked component of emergency medicine. Clinicians in Emergency Departments (EDs) across the United Kingdom (UK) regularly care for dying patients in fast-paced, high-pressure environments that challenge their ability to deliver compassionate, person-centred care. This study explored how ED staff experience and deliver EOL care, and the personal, professional, and organisational factors that shape their practice.Method and Design Semi-structured interviews were conducted with doctors, advanced clinical practitioners (ACPs), and nurses working in UK EDs. Recruitment was open to clinicians directly involved in EOL and Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decision-making, using professional networks and social media to ensure diversity in geography, grade, and background. Interviews explored preparedness, confidence, communication, teamwork, and emotional impact. Data were transcribed verbatim and analysed using Braun and Clarke’s reflexive thematic approach, incorporating iterative coding, constant comparison, and peer review to ensure analytical rigour.Results and Conclusion Seventeen participants contributed to the dataset, representing a range of roles and seniority across UK emergency medicine. Analysis identified five overarching themes reflecting the realities of providing end-of-life (EOL) care in the emergency setting. Learning through experience dominated, with most describing minimal formal training and reliance on experiential learning to build confidence. The environment as a barrier was a persistent challenge, with crowded, noisy spaces undermining privacy and dignity. Communication under pressure required clarity, honesty, and emotional sensitivity when discussing deterioration, resuscitation, or treatment escalation. Teamwork and advocacy influenced care quality, with nurses and advanced clinical practitioners leading on emotional support and practical comfort. Emotional and moral impact was profound: clinicians reported distress when unable to meet their own standards but found meaning and pride in providing dignity and calm for dying patients. EOL care in emergency medicine remains a balance between compassion and constraint.