Since 2005, Grey’s Anatomy has thrown plenty of danger at its characters, from cancer to gunmen to bombs put inside patients. In this show, vehicles that seem to come out of nowhere crash into scenes and planes fall out of the sky. Many characters don’t make it out of Seattle Grace Mercy Death in one piece—and those that do aren’t always looking to come back. And some leave of their own accord, tired of working at the hospital with the worst luck in the country, if not the world.
More than 20 characters have left Grey’s since its premiere, either in a body bag or on their own two feet. Ahead of its 20th season, we looked at their exits, from the worst send-offs to the very best. For the purposes of this list, we are only considering series regulars and how they left the show in that capacity, disregarding how they may have returned as guests later on. Though Meredith Grey (Ellen Pompeo) technically left the show as a series regular in season 19, her guest appearances and overall presence on the series excludes her from this list.
These exits are ranked on levels of sadness and tastefulness, taking into account the importance of the character on the show as well as whether their send-off did that character justice. (If you were killed in a car crash, for example, that is not exactly tasteful). Here, a ranking of how Grey’s Anatomy characters exited the show.
Erica Hahn (Brooke Smith)
Preston Burke’s replacement didn’t do a whole lot in her time on the show, but she’s the reason why Callie Torres begins exploring her sexuality, which becomes a huge part of the character’s identity in the rest of the series. Hahn isn’t even properly written off—her final scene is just her walking toward the parking lot in a season 5 episode, which is neither tasteful nor tear-inducing.
Sadness = 0, Tastefulness = 0 | Score = 0
Leah Murphy (Tessa Ferrer)
Another character who isn’t given an actual sendoff is Leah Murphy, who was fired from the hospital at the end of season 10 and then randomly returns in season 13. She starts working with Maggie Pierce, and then just disappears.
Sadness = 0, Tastefulness = 0 | Score = 0
Tom Koracick (Greg Germann)
Neurosurgeon Tom Koracick’s claim to fame was having an affair with Teddy Altman while she was engaged to Owen Hunt. Teddy and Owen end up together, and Tom was left with little else to do (besides get COVID-19 a season later). He ends up following Jackson Avery to Boston in season 17.
Sadness = 0, Tastefulness = 2 | Score = 2
Preston Burke (Isaiah Washington)
By the time the season 3 finale rolls around, Burke has forced his fiancée into boxes that don't fit her. Cristina Yang is not one of those girls who dreams about her wedding day or loves getting dressed up, but she does it for him. She even lets his mother rip her eyebrows off. And what does Burke do? He leaves her minutes before they are set to tie the knot! Yes, he realizes that she’s better off without him, and that he doesn’t want her to be a person she’s not. But that seems like the kind of thing you tell your partner before she’s about to walk down the aisle! His exit is sad for Cristina, who is left broken in the aftermath, so it is sad for all of us. (Also, how can one not be moved by Cristina in their empty apartment being suffocated by her wedding dress as Ingrid Michaelson’s “Keep Breathing” plays?)
Sadness = 4, Tastefulness = 0 | Score = 4
Andrew DeLuca (Giacomo Gianniotti)
While Meredith is in her COVID-induced coma in season 17, her boyfriend, now an attending, is fatally stabbed. If you’re a viewer of the show and confused by this because you don’t remember it happening, that’s because it played out on the Grey’s Anatomy spin-off Station 19. During Grey’s, DeLuca gets sent to the hospital and later meets Meredith on her “afterlife” dream COVID beach, where they say goodbye. If your cause of death occurs off-screen, or on another TV show altogether, the tastefulness score is automatically 0. Those are just the rules!
Sadness = 5, Tastefulness = 0 | Score = 5
Shane Ross (Gaius Charles)
Though it happens fairly abruptly, Ross decides to leave the hospital in season 10 so he can follow his teacher, Cristina, to Switzerland. He gives a pretty adamant speech to her about why he should join her abroad, and she immediately says yes. This seems like a pretty decent way to exit (alive, uninjured, off to be taught by one of the greatest cardiothoracic surgeons of all time).
Sadness = 0, Tastefulness = 5 | Score = 5
Stephanie Edwards (Jerrika Hinton)
Stephanie Edwards has endured her fair share of tough deals in her four seasons: an intern in her class is fatally electrocuted, her boyfriend interrupts a wedding and runs off with the bride, and she falls in love with a patient who dies, among other things. In the season 13 finale, Stephanie’s held at knifepoint by an unhinged patient, and ends up setting him on fire in order to save herself and the little girl in her company. She survives, with extensive burn injuries, and quits her job to travel the world.
Sadness = 2, Tastefulness = 4 | Score = 6
Maggie Pierce (Kelly McCreary)
In season 19, Meredith’s half-sister has to choose whether to work on her deteriorating marriage or take the job of her dreams in Chicago. She decides on the latter (sorry to her husband!) in a two-part sendoff that includes a cameo from her birth mother Ellis Grey (Kate Burton). A Grey’s character who gets to leave the hospital alive without enduring a traumatic event? The writers must have really liked her!
Sadness = 2, Tastefulness = 5 | Score = 7
Jackson Avery (Jesse Williams)
Another character who gets to leave on a happy note is plastic surgeon Jackson Avery. In season 17, Jackson moves to Boston to run his mother’s foundation after convincing his ex April to bring their daughter there and essentially give their relationship another shot. It’s a heartwarming ending for the character—as he drives past the hospital, a montage of his more than 10 seasons on the show plays. Plus, Jackson’s alive and healthy and his second chance with April means that at least one popular Grey’s couple might have a rare happy ending.
Sadness = 2, Tastefulness = 7 | Score = 9
Cormac Hayes (Richard Flood)
One of Meredith’s former love interests, pediatric surgeon and widower Cormac Hayes decides he’s had enough of the drama at the hospital when he learns of Owen’s dangerous secret (helping vets with assisted suicide). Instead of letting Owen’s confession haunt him for the rest of his career, Hayes moves back to Ireland with his family to start over. This is a respectable choice. Before he leaves in season 18, he tells Meredith that she’s helped him open himself up to love again, which is sweet.
Sadness = 3, Tastefulness = 6 | Score = 9
Callie Torres (Sara Ramirez)
Callie Torres’ last season is confusing. The trailblazing character, who was half of a core couple on the series, ends her years-long marriage with Arizona Robbins in season 11, only to date Penny Blake (Samantha Sloyan), the doctor who killed Derek Shepherd, in season 12. When Penny decides to move to New York, Callie wants to follow her (after, like, two seconds of dating) and bring her and Arizona’s daughter with them. Callie’s final season is characterized by a nasty custody battle, which she ultimately loses, and little to no resolution in her relationship with Arizona. Calliope Torres deserved better!
Sadness = 6, Tastefulness = 2 | Score = 8
Alex Karev (Justin Chambers)
Alex Karev’s character arc was special to watch. In his 16 years on the show, Alex grew from an obnoxious, misogynistic intern (never forget when he called Meredith a nurse) to be a caring, complex, and generous pediatric surgeon. That arc is what makes his “send-off” so painful. Fans were caught by total surprise when Justin Chambers announced that he was leaving the show in the middle of season 16. After being largely absent from the season, Alex isn’t even featured on screen in his last episode. Instead, through voiceover and flashbacks, Alex explains to the most important people in his life that he moved to be with Izzie Stevens (!) who was raising their twins (!) in Kansas. This is a crazy turn of events for no less than 100 reasons. It’s nice (if random) to know that Alex and Izzie are endgame, but it also makes no sense that Alex would leave his wife to go run off and be with the woman who broke his heart and share that news via snail mail.
Sadness = 10, Tastefulness = 0 | Score = 10
Derek Shepherd (Patrick Dempsey)
Typically, a major character’s untimely demise happens during a finale of Grey’s Anatomy. But Derek Shepherd’s was a few episodes before in season 11—and no one saw it coming. After helping the survivors of a car accident, the revered neurosurgeon is hit by a semi-truck, taken to a hospital that does not give him a proper scan to catch his brain bleed, and later succumbs to his injuries. Derek’s death comes just as he and Meredith recommit to their marriage, and he dies without ever meeting their third child. He’s killed off in a senseless way—some could even say his send-off was screwed up and random and mean. But his death also helped usher in a new era of Grey’s. Without McDreamy, Meredith can finally be the sun (more on that later).
Sadness = 10, Tastefulness = 1 | Score = 11
Izzie Stevens (Katherine Heigl)
Most fans thought Izzie Stevens was on her way out in season 5. She was diagnosed with cancer and things weren’t looking good toward the end. Somehow, she survives, just to be written off abruptly in the next season. She gets fired from the hospital and can’t save her marriage, so she leaves her heartbroken husband Alex behind to begin a new adventure elsewhere. Because she’s not dead—and the Grey’s writers really could have killed her off—her tastefulness score is high. The door is left open for her to return, which she sort of did through Alex’s exit, in a convoluted way.
Sadness = 5, Tastefulness = 6 | Score = 11
Arizona Robbins (Jessica Capshaw)
Arizona Robbins and April Kepner have the same score here. It’s fitting, since they both said goodbye in the season 14 finale. Their characters had a deep connection and were hilarious together, making their send-off bittersweet. Arizona left on good terms: she moved to New York for her daughter, and so that she could (possibly) rekindle things with Callie.
Sadness = 5, Tastefulness = 6 | Score = 11
April Kepner (Sarah Drew)
Like Arizona, April left with her head held high. After quitting the hospital to pursue more meaningful work, helping the homeless communities of Seattle, April is proposed to by her ex-fiancée in her final moments on the show. She gives an enthusiastic yes—and is ready to move on from her time at the hospital. (This is a win, but an even bigger surprise comes down the line when Jackson knocks on her door years later.)
Sadness = 5, Tastefulness = 6 | Score = 11
Nathan Riggs (Martin Henderson)
If you’re wondering how it is possible that a character who was only on the show for three seasons, just to play Meredith’s love interest, is so high on this list, that is fair. However, Nathan Riggs, the cardiothoracic surgeon who teaches Meredith she can want love again, is given one of the sweetest send-offs of all time. Riggs arrived in season 12 with plenty of baggage to bond over with Meredith: his fiancée, Owen’s sister Megan (Abigail Spencer), had been missing for years, ever since they served together overseas. In the season 13 finale, Megan is miraculously found. Her reunion with Nathan is weepy and wonderful—and his decision to go live with her in Los Angeles the following season is totally warranted. (Though, in season 18, Megan reveals that they later broke up, which is a devastating twist.)
Sadness = 4, Tastefulness = 8 | Score = 12
Lexie Grey (Chyler Leigh)
Killed in a plane crash just 15 minutes into the season 8 finale, Lexie Grey’s death was a complete shock and absolutely gutting. In her final moments, the love of her life, Mark Sloan, holds her hand and promises that they are going to be together forever. Then, she stops breathing. This was a heartbreaking way to go for a beloved character whose romance with McSteamy was one for Grey’s history books. Ultimately, her cause of death was both ridiculous and gross (sucked out the side of an airplane and crushed under debris). Why couldn’t she have walked out alive like so many others before her?
Sadness = 10, Tastefulness = 2 | Score = 12
George O’Malley (T.R. Knight)
Many people can recite what happened to George O’Malley without ever watching Grey’s Anatomy. This was a peak water cooler moment: in the season 5 finale, everyone’s favorite doctor is dragged by a bus after pushing another woman out of the way. When he arrives as a patient at the hospital, his face is so distorted that nobody recognizes him, until he draws his nickname, “007,” inside Meredith’s hand. He’s rushed into emergency surgery at the same time as Izzie—and the episode ends with a dream sequence as Izzie, in the dress she wore when her fiancé Denny died, sees George in his army uniform. His death is confirmed at the beginning of season 6 and he’s even given a funeral—a rarity on Grey’s.
Sadness = 10, Tastefulness = 7 | Score = 17
Mark Sloan (Eric Dane)
Mark just couldn’t live without Lexie. Though he initially survives the plane crash, his injuries are too extensive, and he’s put on life support in Seattle. The season 9 premiere reveals unseen flashbacks, including a moment from Arizona and Callie’s wedding where he says that he wants to grow old with Lexie. The episode, which ends as Mark dies, is a touching tribute to the character.
Sadness = 10, Tastefulness = 9 | Score = 19
Addison Forbes Montgomery (Kate Walsh)
Addison made a stunning entrance at the end of the first season of Grey’s Anatomy when she rocked the world by announcing herself as Derek’s wife. But the anti-hero quickly became a series favorite as she navigated her relationships with both Derek and Mark, and proved herself to be a funny and complicated character, far more interesting than the men she slept with. Her exit, in season 3, is sad for fans who grew to love her and had to say goodbye to one of the best characters ever on the series. But one of her last episodes as a series regular is the back door pilot to Private Practice, which ended up running for six seasons on ABC. If you get a whole spin-off show centered on your character, your tastefulness score is automatically a 10. That’s just how it works!
Sadness = 10, Tastefulness = 10 | Score = 20
Cristina Yang (Sandra Oh)
Most of season 10 builds up to Cristina’s exit, in which she finally leaves the hospital to pursue more groundbreaking opportunities working with Burke (!) in Switzerland. Cristina outgrew Grey Sloan and needed something new, especially after breaking up with Owen (for good this time). Before leaving for the airport, Cristina brings Meredith into an on-call room so they can dance it out, one final time. The twisted sisters’ love for each other is the beating heart at the core of Grey’s, and it is really celebrated here as they go their separate ways. Crucially, Cristina’s parting words to Meredith are that she needs to prioritize herself over Derek: “He’s very dreamy, but he is not the sun. You are.”
Sadness = 10, Tasteful = 10 | Score = 20
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Write to Annabel Gutterman at annabel.gutterman@time.com