The pilot for the popular TV series is set during 24 frantic hours in the lives of a group of doctors, nurses, and staff members of a busy emergency room at a Chicago hospital. They deal with the seemingly endless casualties that stumble into their place of employment. The central characters are the chief resident and family man Dr. Mark Greene, who is considering a job in private practice due to pressure from his demanding law student wife Jennifer; outgoing Dr. Doug Ross, who deals with cases in his own personal way; straight-arrow Dr. Susan Lewis, trying to get by another long 36-hour shift; inexperienced third-year med student John Carter; cocky surgical resident Dr. Peter Benton; and troubled chief nurse Carol Hathaway.

Mark's wife arrives in the ER with the news that she has passed her bar exams but several members of the staff interrupt their intimate celebration. Greene treats an elderly woman whose husband isn't ready to let her go. It's been eight weeks since Hathaway's attempted suicide, but Doug Ross has yet to bring himself to visit the woman he went out with for two years. Susan Lewis saves a newborn who is brought into the ER choking. She also argues with the psychiatric attending who refuses to admit a patient suffering from dementia. Carter finds himself having to care for a group of German tourists who are suffering from food poisoning. He also treats a young flirt with a rash. Benton treats a recent surgery patient and finds his correct diagnosis overturned by the man's physician. Susan Lewis treats a family struck by a drunk driver. The husband and daughter will survive but there is little hope for the woman. The drunk driver is also brought in suffering from only a few scratches.

Carol Hathaway returns to work after her suicide attempt. Doug Ross still feels guilty about what happened. An ER patient found walking the streets takes to singing, constantly. Susan Lewis has a run-in with the cardiologist on duty, Dr. Kayson, when he disagrees with her treatment of a heart attack victim. At a case review session, she gets very little support from her colleagues. She also treats a woman who is dying of leukemia and who has good advice for Hathaway. Greene treats a woman who has obviously been beaten by her husband but can't get to agree to get help.

Mark Greene's wife Jen gets a position clerking with a Federal judge. Unfortunately, it's in Milwaukee, 2 hours away and she wants Mark to look for a job there. Greene and Susan Lewis treat Samuel Gasner, a man who has been waiting for a heart transplant and who will not survive the night unless a donor can be found. John Carter is worried that his latest paramour may have left him with a souvenir of their sexual encounter. Doug Ross treats a young girl suffering from severe asthma but whose mother can't afford her medication. Benton treats Ivan the liquor store owner who is shot for the third time in as many weeks.