Grey's Anatomy: What The Cast Looked Like In The First Episode Vs Now

Grey's Anatomy has graced our screens for 13 years and counting, but there's the sense that it will soon be drawing to a close. Since its first airing, the show has won a number of Golden Globes and Emmys, fantastic reviews from audiences and critics, and a widespread viewership of loyal fans.

Aside from its high stakes and big drama, one of the defining characteristics of the show is its high turnaround in cast members. Grey's Anatomy is renowned for its shocking death toll, and many of the original cast members have met their demise or departure in one way or another. Every episode has us on the edge of our seats, wondering how we'll get through the emotional rollercoaster of seeing our favorite characters survive endless tragedies and heart-breaking events.

Because of the show's affinity for dramatic exits and curveball catastrophes, there have been a few recurring faces over the years and many newcomers to the hospital. Because the series has been running for so long, it's natural that many of these characters have changed drastically since their first on-screen appearance.

Here we take a look at how some of the major characters have developed over the years, many from bright-eyed young doctors and interns into weathered veterans of medicine. It's time for a Seattle Grace reunion.

Here's Grey's Anatomy: What The Cast Looked Like In The First Episode Vs Now.

20 Sandra Oh (Cristina Yang)

When Grey’s Anatomy first aired, we all knew Cristina Yang as the cold yet brilliant doctor who was essentially Meredith Grey’s sidekick. In a lot of ways, she was the more likeable counterpart to Meredith’s often annoying character. We didn’t often get to see Cristina’s vulnerable side, but when we did, these moments were truly golden and made for the most memorable scenes in the show.

Everyone remembers that episode when Burke ditched her at the altar, and although it sent Cristina into meltdown mode, we got to see Sandra Oh channel her best self to give an incredible performance as her character Cristina.

After a decade of drama, Cristina decided to leave Grey-Sloan Memorial Hospital and became the head of heart surgery where her former fiancé worked. In terms of appearance, Cristina didn’t change all that much, but there was definitely a visible resilience and strength that she developed over the years.

19 Justin Chambers  (Alex Karev)

Was there a bigger jerk than Alex Karev (Justin Chambers) in season one? Simply put, no. Not only was Alex ridiculously arrogant, he was also a major lothario, sleeping around with pretty much every single nurse and surgical intern he could “charm.”

Fast forward a little over a decade, and we’ve got a whole new perspective on Karev.

After going through ordeal after ordeal, it’s safe to say that Grey's Anatomy fans love his character now, especially as he’s become an unbelievable peds surgeon. In terms of looks, he is still as handsome as he once was, with the added bonus of some age-given maturity and a softness to his face that wasn’t there in his days as a jerk.

Alex Karev is one of the original cast members that has managed to keep his place on the show, and it’s a relief to see his character having developed in a positive way over the years.

18 Ellen Pompeo  (Meredith Grey)

The star of the show and the series’ namesake, Meredith Grey (Ellen Pompeo) started off in season one as a surgical intern. She has come a long way since then, and has had to face countless struggles and losses over the years. We’ve seen her change from being a keen student, eager to learn everything she can, to being a hardened veteran of the hospital, and a great mom to boot.

Meredith is still very much the head of the show, but she shares more of her screen time these days with her co-stars. Her appearance has shifted over the years as she’s aged and gone through so much pain and hardship, but her beauty and spark has never left her. The lines we see on her face are a testament to her character and the fortitude she has built up over her many years at the hospital.

17 Patrick Dempsey (Derek Shepherd)

It’s safe to say that Derek Shepherd was a firm favorite with Grey’s Anatomy fans and there was definitely a reason he was known as “McDreamy.” When we first met Derek Shepherd in season one, he was the gorgeous, swoon-worthy hunk that captured Meredith’s heart. Over the years, as Shepherd went through some awful times including being shot, surviving a plane crash, and on a much better note, becoming a father, he developed into being a bit of a silver-fox, his hair turning more salt-and-pepper than dark brown.

Hey, living through all that would age a person.

Then came his unexpected exit in season 11, when fans were outraged that he died. Since leaving the show, Patrick Dempsey has starred in Bridget Jones’ Baby and the TV mini-series The Truth About the Harry Quebert Affair.

16 Katherine Heigl  (Izzy Stevens)

While Katherine Heigl might not have a huge fan base these days, it can’t be denied that she played her character Izzy Stevens admirably during her time on Grey’s Anatomy. Her performance was deemed so good in fact, that she even won an Emmy for it.

Although Izzy Stevens isn’t a character whom we took very seriously in season one, she quickly became a force to be reckoned with as she battled the many trials and tribulations that befell her, most notably, surviving her cancer diagnosis.

Other than her hair changing from long to short, Izzy Stevens didn’t go through much of an appearance metamorphosis.

Katherine Heigl left the series after six seasons, but during her time on the show, she transformed her character Izzy from being just a pretty ingenue into being an experienced, hardened survivor.

15 Chandra Wilson (Miranda Bailey)

When we first met Miranda Bailey in season one of the show, we knew her as a tough-as-nails force of nature that didn’t mess around. Her softer side shone through when someone really needed help, but this no-nonsense attitude Miranda sported undoubtedly made her one of the best and strongest characters of this first season.

Over time, Bailey hasn’t changed too drastically in terms of her character, although as Chief of Surgery, she is now a lot more human, and a bit softer around the edges.

We can see the years showing on actress Chandra Wilson’s face, and clearly the drama and the toll of the job show up as visible physical changes on her character's features. That being said, Bailey is still the same character we all know and love, who keeps pushing people to be their best selves as she remains on the show.

14 T.R. Knight  (George O’Malley)

T.R. Knight’s character George O’Malley was the endearing, lovable intern whom everyone adored. When he started off in season one, fans of the show were captivated by his sweetness, although many wished he would also toughen up a bit.

Well, it’s a lesson that taught us to be careful what we wish for, as George definitely toughened up, and met his maker as a result. That’s right, George O’Malley died when he decided to quit his job and join the army, and on his way home, sacrificed his own life to save a girl from getting hit by a bus.

It was a tough blow for all fans of the show, especially as we’d watched George develop from a soft, round-faced intern into a leaner, army-ready man.

13 Sara Ramirez  (Callie Torres)

Our first encounter with Sara Ramirez as Callie Torres was in season two of the show, and she made a huge impression on fans of the program with her wild, curly hair and her biting sass. She was bossy, strong, and quickly became a fan-favorite, particularly amongst the LGBTQ community as she was revealed to be one of the first openly bisexual characters on television.

Callie endeared us when she stood by the hospital interns through the good times and the bad, and her relationship with Arizona Robbins filled all who watch the show with joy. Callie Torres left in season 12, but over the years she really did transform. We saw her visibly mature from season to season, and her rounded features become leaner and more defined as the year went by.

12 Jessica Capshaw (Arizona Robbins)

Jessica Capshaw’s character Arizona Robbins is still on the show after her debut in season five, and initially made us all fall in love with her for her quirkiness and hilarious sense of humor. She brought a lot of laughs into a place that was constantly surrounded by darkness and bad luck, and her romance with Callie Torres was wonderful.

Despite being sunny and bright most of the time, Arizona struggled after losing her leg in the plane crash. She quickly turned from being a much beloved member of the show to falling out of fans’ good books when she cheated on Callie with another woman.

As for her appearance, generally Arizona’s demeanor went from bubbly and cheery, to being more serious and hardened by all the tragedy she had gone through.

11 Jesse Williams (Jackson Avery)

Jesse Williams had very few acting credits to his name when he started off his role as Jackson Avery in season six, and just like Williams, Jackson was fresh-faced and full of energy. He made his initial appearance with the Seattle Grace-Mercy West merger happened, and fans’ first impressions of Jackson were that he was a little mean and had an agenda to just getting ahead.

Jackson is still very much present on the show, but has developed into a much sweeter, kinder character.

His relationship with April Kepner has been a big part of his storyline, but we have also seen him transform into a great surgeon over the years, becoming Head of Plastic Surgery. He’s still very much the pretty boy he was when we first met him, but if anything, his looks have just become even more rugged and beautiful than they ever were before.

10 Sarah Drew (April Kepner)

April Kepner has been a main character on Grey’s Anatomy since season six and is still a remaining member of the team. She, like Jackson Avery, joined Grey Sloan Memorial Hospital after the merger with Mercy West. April Kepner got a reputation with fans as being one of the whiniest, most annoying characters on the show, but the drama surrounding her relationship with Jackson Avery seemed to put her back in people’s good books.

When looking at Sarah Drew as April from her first appearance and now, we can see a maturing and refinement of her overall look.

Just like all the characters on the show, April has gone through her own issues and troubles, which have aged and toughened her up from how she was when she first joined the team.

9 Kevin McKidd  (Owen Hunt)

Kevin McKidd’s character Owen Hunt is the former soldier who became the hospital’s current Head of Trauma, having made his debut on the show in season five. We saw him have an on again, off again relationship with Cristina Yang, suffer from horrible PTSD from his time in Iraq, and eventually get married to Amelia Shepherd.

He is known for being one of the hospital’s top surgeons, despite his often unorthodox methods.

People’s opinions of Owen Hunt are a mixed bag, with many still believing he should really be with Cristina Yang instead of Amelia Shepherd. His character has largely remained consistent in terms of looks, although the lines on his face have deepened somewhat. Even so, that fiery red hair of his has yet to fade!

8 James Pickens Jr. (Richard Webber)

Richard Webber, played by James Pickens Jr., was first introduced to us as the Chief of Surgery in season one before stepping down and becoming senior attending surgeon after his bouts of alcoholism and the death of wife Adele.

Still a staple of Grey’s Anatomy, Webber has always been a character we have looked to in order to offer wisdom and a voice of reason. Always caring and supportive when people are in need, Richard Webber has faced his fair share of misfortunes, but has risen above them thanks to his determination and strength.

James Pickens Jr.’s character is showing some signs of ageing these days, and the white hairs are coming in fast and strong. However, this just adds to his wise persona and his dignified air.

7 Camilla Luddington  (Jo Wilson)

Compared to most of the other Grey’s Anatomy characters we’ve seen so far, Camilla Luddington’s Jo Wilson is fairly new to the GA clan.

First appearing in season nine, Jo Wilson has become one of the characters with the most shocking backstory, namely not actually being called Jo Wilson, but rather Brooke Stadler. Her past relationship with her abusive, estranged husband Paul shocked all GA fans, and made for some very high-stakes drama in the series.

Since Jo is relatively new to the series, we haven’t been able to see her develop for as long as some of the other cast members.

In terms of appearance, not much has changed since her first outing, but the tension and turmoil of her past has made its way into her overall demeanour.

6 Caterina Scorsone (Amelia Shepherd)

Amelia Shepherd is Derek Shepherd’ younger sister, and made her debut as a guest star on Grey’s Anatomy (first appearing in Private Practice) in season seven, before moving into a full-time role on GA in season 10.

Over the years, Amelia transformed from being a troubled young woman into a brilliant neurosurgeon.

Having been dealt a tragic storyline, however, of surviving a massive brain tumor, Amelia obviously went to a dark place, swapping her previously sunny disposition to one of struggle and pain. We’ve seen Amelia transform over the years, changing from a moody young woman into a talented doctor, and seeing her inner strength shine through as she’s had to tackle these trying circumstances.

The future is looking brighter for Amelia, though, and with that, hopefully a healthier, better mental place.

5 Kate Walsh (Addison Montgomery)

Addison Montgomery made her first appearance on Grey’s Anatomy at the end of season one, and became a series regular during series 2 and 3 before moving on to feature in the spin-off of the show, Private Practice. She won fans over with her humor, relatability, and fiery ambition, and of course, how could any of us forget the mega-bombshell she dropped on Meredith Grey when she announced she was “Dr. Addison Shepherd”? The shock was very, very real.

Addison went from being the doctor we all loved to hate to being one of the most missed characters when she moved on from the show.

Her last appearance on GA was in the parallel universe episode in season 8, but there’s no doubt fans want her back for more.

4 Brooke Smith (Erica Hahn)

It was a huge shock for fans of Grey’s Anatomy when the beautiful, outspoken character Erica Hahn, played by Brooke Smith, was unexpectedly cut from the show in season 5. Erica came onto the GA scene in tangent with Callie Torres beginning to explore her bi orientation. Callie and Erica began a hot, romantic fling, but Erica got unnerved by Callie’s inability to fully come to terms with herself, thus deciding to end the relationship and leave the hospital in one fell swoop.

This storyline was sadly cut short as the network reportedly had some issues with the direction this plot line was taking and with Hahn’s character herself.

Since leaving Grey’s Anatomy, Brooke Smith has made numerous TV and film appearances, including roles in Law & Order: Special Victims Unit, American Horror Story, Bosch, Ray Donovan, and Bates Motel.

3 Preston Burke (Isaiah Washington)

Isaiah Washington originally auditioned for the role of Dr. Shepherd, but was cast instead as Preston Burke, who famously saw his end on Grey’s Anatomy when he left fiancee Christina Yang at the altar in the third season finale of the show.

Fans were left wondering if Burke would be returning to the show for season 4, but were left aghast when news broke out that the actor’s contract had not been renewed due to reports that Washington had used a homophobic slur directed at T.R Knight, his coworker who played George O’Malley on the show.

Since his departure from Grey’s Anatomy, Washington has written a memoir, appeared on The 100, and even came back for a guest appearance in season 10 of Grey’s Anatomy as part of Christina Yang’s farewell.

2 Teddy Altman (Kim Raver)

Kim Raver’s character Teddy Altman made her first appearance on Grey’s Anatomy in season 6 and continued to play her cardiothoracic surgeon role until season 8 when she left the hospital in order to take a job with the US military. Teddy had been left broken after the devastating end of her husband Henry, and her leaving Seattle Grace was certainly a push for her to move on with her life.

After being absent from the show for many seasons, Teddy made a return in season 14, and her character arc has been developed for her to make a return in season 15, presumably to pursue her relationship with Dr. Owen Hunt.

Aside from her welcome return to Grey’s Anatomy, Kim Raver is also appearing in ABC’s Designated Survivor.

1 Denny Duquette (Jeffrey Dean Morgan)

Grey’s Anatomy has had a lot of departures in its 14 seasons, but arguably the most upsetting demise was that of Jeffrey Dean Morgan’s character Denny Duquette in season 2. Denny was beloved by fans, and it was a heartbreaking moment seeing Denny pass away after he had survived cut LVAD wires and a heart transplant, only to have a stroke right after he had proposed to Izzie Stevens.

This was truly one of the most poignant and devastating deaths in TV history, and it was a sad day having to bid Denny goodbye. He made a special guest appearance as a ghost in several later episodes, but his return in this way was met with mixed reactions from fans.

Since leaving Grey’s Anatomy, Jeffrey Dean Morgan has gone on to star in The Walking Dead and The Good Wife, among many other projects


What Grey's Anatomy character do you miss most? Sound off in the comments!

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