Summary

• Grey's Anatomy covers heartbreaking losses and difficult decisions, making for poignant, tear-jerking episodes.
• The show allows viewers to feel what characters feel, creating a cathartic viewing experience through shared sadness.
• Iconic romances, intense personal drama, and tragic deaths make up some of the show's most memorable and emotional moments.

Content Warning: This article contains references to murder, death, human trafficking, shootings, and infant loss.

In ABC’s Grey’s Anatomy, shocking moments are almost the norm, but there's also quite a bit of sadness for the characters among those story moments. As a drama that has been going on for more than 18 seasons, the show has covered just about every medical complication imaginable. Not to mention, the show’s main characters have gone through a lot themselves. It's enough to send both the characters and viewers into fits of tears. Some of the episodes that feature these moments are among the show's best.

The saddest episodes of Grey's Anatomy can also be some of the most poignant. They allow the audience to connect with the characters as they suffer heartbreaking losses or grieve the outcomes of difficult decisions. Sadness that transcends the television program and allows the audience to feel what the characters are feeling provides for a cathartic television viewing experience.

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15 "Didn't We Almost Have It All?"

Season 3, Episode 25

Among all the doctors on Grey’s Anatomy, Cristina was, undoubtedly, one of the most brilliant surgeons ever featured. Fans also may recall that she was incredibly competitive from day one, eager to scrub in on surgeries and gain as much experience in the OR as possible. Her drive and cutthroat approach to the job eventually caught the attention of a more experienced surgeon, Preston Burke (Isaiah Washington).

As time went by, Cristina and Preston started dating each other and, at one point, they even got engaged. However, in this episode, Preston decides to call off the wedding as Washington exited the show. While fans weren't exactly disappointed to see Preston go, they were a little heartbroken for Cristina (who had been humiliated in front of their family and friends). She had deserved so much more than this terrible treatment. Her heart-wrenching request for help getting out of her wedding dress is one the audience will never forget.

14 "One Day Like This"

Season 14, Episode 17

Season 14 was a pivotal one for April in terms of her character arc, as fans saw her go through a crisis of faith. While it was a storyline that went on for several weeks, the writers did manage to find a way to reconcile her faith in one of the saddest Grey's Anatomy episodes, "One Day Like This," through Eli (a rabbi who had been admitted to the hospital with toxic epidermal necrolysis).

Eli might have only been a minor character, but his words of wisdom and brief interaction with April touched the hearts of many fans. This was not only because the viewers could feel the intensity and passion Sarah Drew and Saul Hersh Rubinek put behind the words, but also because the scene contained one of the saddest patient deaths Grey's Anatomy fans had ever seen as Eli, unfortunately, passed away not long after, believing April to be his wife when he did.

13 "Things We Said Today"

Season 9, Episode 10

In this episode, it was discovered that Adele Webber needed surgery due to an undiagnosed abdominal aortic aneurysm. Determined to save her, Bailey made the decision to delay her own wedding ceremony, so she could personally operate on Richard’s wife.

Unfortunately, Adele suffered a heart attack and Richard only informed Meredith about Adele’s passing during Bailey’s wedding ceremony. The sorrow on his face was enough to make anyone weep, especially since he had a flashback to his and Adele's wedding. Many fans also thought it was quite a sad episode since it was the final episode that Loretta Devine appeared in.

12 "Helplessly Hoping"

Season 17, Episode 7

Season 17 was one of the most heartbreaking seasons for many viewers as it involved a lot of death and serious storylines. However, no one ever expected that they would lose another fan-favorite character, who was on his way to becoming one of the most promising surgeons.

After months of him investigating a human trafficking case, Andrew DeLuca was sadly murdered in "Helplessly Hoping" while trying to bring the criminals to justice. While many fans thought it was a well-written story and all the actors involved, particularly Giacomo Gianniotti and Stefania Spampinato, delivered powerful and emotional performances, they were nevertheless heartbroken that DeLuca's character journey ended on such a tragic note in one of the saddest Grey's Anatomy episodes.

11 "Suddenly"

Season 8, Episode 10

There have been plenty of iconic romances on Grey's Anatomy that have had a profound effect on fans, but one of the most underrated ones was Henry and Teddy's relationship. It may have started as a marriage of convenience, but the couple genuinely fell in love with one another as Teddy supported Henry with his operations and condition.

Sadly, this didn't last for very long as Henry sadly died in the episode "Suddenly." Not only were the fans devastated by the outcome, but several characters' relationships, including Cristina and Owen's, were affected in the long run too, since he didn't tell her she was operating on her mentor's husband.

10 "Be Still, My Soul"

Season 13, Episode 18

Although she arrived near the end of season 10, it took 3 years before the writers delved into Maggie's personal life properly. Other than knowing she is one of the best cardiothoracic surgeons Grey's Anatomy has ever had and that she was the long-lost daughter of Richard Webber, fans had yet to learn what her upbringing was like or meet any of her parents.

However, that all changed by season 13 when Maggie's mother, Diane, visited. Straight away, it was clear that Maggie had adored her and hung onto her every word. Sadly, Diane wasn't in the series for long as she sadly passed away from cancer in "Be Still, My Soul," with Maggie at her bedside. It was certainly an emotional episode, since it was clear that Maggie was struggling under the weight of all the recent changes and no one knew how she would cope without her mother.

9 "Going, Going, Gone"

Season 9, Episode 1

The season 9 premiere delved into the aftermath of the plane crash that rocked Grey's Anatomy. At this point, the doctors had already gone back to work. However, nothing was the same as many of them were physically and emotionally changed. Sadly, fans were also forced to say goodbye to another fan-favorite character, as Mark died as a result of the injuries he sustained in the plane crash.

Where season 8 had been quite comical and light-hearted, this episode showed fans that they would not be getting another one like it. With Mark, Lexie, and Teddy Altman having made their departures and a new bunch of interns introduced, it was like the show was changing (which some were a little sad about). They were also disheartened to see that Mark didn't get his happy ending, since they knew how hard he had fought to get back to Callie and his daughter, Sofia. His end made for a particularly sad Grey's Anatomy episode.

8 "Flight"

Season 8, Episode 24

"Flight" is arguably even sadder of an episode than "Going, Going, Gone" because of how events fall. In this episode, a medical team made up of Meredith, Cristina, Derek, Mark, Lexie, and Arizona gets involved in a plane crash. After regaining consciousness, the doctors struggled to treat each other and stay alive after help didn’t arrive right away.

Among them, the worst off was Lexie who ended up getting pinned under a part of the plane. And when it became evident that they couldn’t free her, Lexie herself realized that she was dying. In a bittersweet moment, she admitted to Mark that they were “meant to be” before taking her last breath. Lexie was such a bright light amid heavier storylines in the show that it hit the audience hard. It was certainly a death that fans carried in the years to come as Meredith became darker and the storylines a lot more intense.

7 "Sanctuary"

Season 6, Episode 24

This season 6 episode opened with Meredith’s voiceover explaining that the hospital can be a scary place for a lot of people. It’s an ominous message, considering that a shooter named Gary Clark would start a killing spree inside the hospital a few moments later.

Since the episode contained mature themes and graphic violence, many fans felt that the writers handled the hospital shooting responsibly. It's a difficult topic to include in any form of entertainment, given the prevalence of gun violence in the United States. It was certainly one of the more heartbreaking Grey's Anatomy episodes too, since many of the main and recurring characters were badly injured or killed.

6 "All I Could Do Was Cry"

Season 11, Episode 11

April had been a deeply religious person throughout her time on the show. That said, fans may recall that her faith wavered slightly when she learned that the first baby that she was carrying had a fatal condition.

In this episode, April and Jackson discovered that their unborn child had type II osteogenesis imperfecta (where the baby’s bones are breaking in her uterus). Although fans knew that it would be such an intense and emotionally raw episode, many fans credit the writers for handling such a sensitive topic responsibly as well as Sarah Drew and Jesse Williams' portrayals too.

5 "Into You Like A Train"

Season 2, Episode 6

One of the saddest Grey's Anatomy episodes also included one of the most heartbreaking patient deaths. It's usually the surgeon's personal drama that usually ends up taking center stage in most episodes. However, in this particular episode, it is the patients and their cases that prove to be the most memorable aspects as their heartbreaking circumstances had fans mourning for weeks. Two patients came into the hospital impaled on the same piece of metal after a train accident, and it was made clear that the survival of both was unlikely.

As all the top surgeons were pulled into Bonnie and Tom's case, everyone knew that the writing would be grueling and intense (especially since their injuries were so severe). However, what truly broke the fans' hearts was the dilemma they were in, as they could only save one of them. After learning both patients' backstories and how kind they were, viewers were devastated when Bonnie sadly passed, with her final words aimed at her boyfriend, telling him that she would still be there if love was enough.

4 "Good Mourning"

Season 6, Episode 1

At the end of season five, fans were shocked to learn that patient John Doe had been George all along. In the premiere episode of season six, he died on the operating table. Heartbreak was evident all over the hospital as doctors started to cry when finding out his identity. Callie was especially inconsolable as she decided whether George’s organs should be donated.

When the season 6 premiere aired, fans had already been on tenterhooks as there had been two characters that were on the verge of dying. While Izzie ended up being fine, it shocked fans to hear that George had died as he was the first main character to die. It also took fans a while to get over the death, since George had been one of the kindest and most considerate people on the show.

3 "Losing My Religion"

Season 2, Episode 27

The second season finale episode dealt with the events following Izzie’s decision to cut Denny Duquette's LVAD wire. Following the incident, Denny received a new heart, and it seemed that he was going to be just fine. Meanwhile, as interns refused to come forward about what happened, they were asked to organize a prom for Richard’s niece, Camille.

While the mood around the hospital was quite celebratory, initially, it soon changed when Denny unexpectedly died. Although Denny and Izzie were certainly not one of Grey's Anatomy's best couples, many fans did feel their hearts break at the sight of Izzie crying over his body - especially since she had been so excited about showing him her dress. It completely rendered the fans speechless because it had been so unexpected. Katherine Heigl's performance in the episode is what truly made it nearly the saddest episode of Grey's Anatomy.

2 "How To Save A Life"

Season 11, Episode 21

Over the years, fans saw the evolution of Meredith Grey and Derek Shepherd’s relationship, starting as a one-night stand and eventually leading to kids and a wedding. Everyone thought they would finally live happily ever after - but not quite.

In this episode, Derek found himself at the scene of a car crash treating victims, only to be involved in a crash himself. He received the worst possible medical treatment and sadly died not long after with Meredith by his side. While a lot of fans disliked the decision to kill him, what truly made this one of the saddest Grey's Anatomy episodes was that it was told from Derek's point of view. He told the story for the viewer, recognizing all the medical mistakes made, and narrating while being completely unable to communicate with other characters. It was heartbreaking.

1 "Fight The Power"

Season 17, Episode 5

The saddest episode of Grey's Anatomy gave Miranda Bailey and her mother the spotlight. This season 17 episode was emotionally charged for many as it offered a realistic view of COVID and the pain that it caused families as loved ones succumb to the disease. In the story, Miranda Bailey learned that her mother, Elena, became infected and sadly passed away.

While Bailey's heartbreaking rendition of "My Girl" did bring tears to the fans' eyes as she comforted her mother in her final moments, it was the context behind the storyline itself that resonated deeply with them (as it closely reflected reality and gave fans an idea of what was going on in the medical sector).

Grey's Anatomy Season 20 will premiere on March 14, 2024, with new episodes available to stream on Hulu after they air on ABC.