12 Most Painful Greys Anatomy Character Exits, Ranked

Over the years, Grey’s Anatomy has become known for its painful character/actor exits. A show that runs for 20 seasons is unlikely to hold onto its entire main cast all the way through. Therefore, Grey’s Anatomy became known for tragic character deaths, with Grey Sloan Memorial Hospital being a magnet for disaster. However, not all the most painful exits from Grey’s Anatomy were executed through the relevant character’s untimely demise.

Some Grey’s Anatomy characters left the show for another job elsewhere or for personal reasons, but their departure was still deeply emotional for the viewers and other characters who had always relied on their presence. On the other hand, some exits are painful because they are tainted with poorer writing that undermines the rest of the character’s arc. Regardless, nearly 20 years into its historical run, Grey’s Anatomy has established itself as a drama unlike any other that will always leave the audience emotionally wrecked when a beloved character leaves the show.

12 Dr. Maggie Pierce (Kelly McCreary)

Final Episode: Season 19, Episode 14, “Shadow Of Your Love”

Meredith’s (Ellen Pompeo) sister Maggie is given the Grey’s Anatomy exit she deserves when she leaves Grey Sloan Memorial for an amazing new job opportunity. Maggie is one of the most intelligent characters in Grey’s Anatomy; a former prodigy and a brilliant surgeon. While the audience may be sad to see her go, she deserves her future success and advancement. The one caveat of Maggie’s exit is how it affected her marriage to Winston (Anthony Hill).

Maggie and Winston had a happy ending when they accepted that they both needed to focus on their careers before they decided to have a long-distance marriage for the time until Winston decides to end things for good. At this point, Grey’s Anatomy is in an endless cycle where everyone’s romantic relationships are eventually doomed. The show wrote Maggie and Winston into a situation where it was best for them to break up, but it is nonetheless sad that it had to end.

11 Dr. April Kepner (Sarah Drew)

Final Episode (As A regular): Season 14, Episode 24, “All Of Me”

April’s impending exit was announced ahead of time, alongside Arizona’s (Jessica Capshaw), so people knew it was coming. While it was possible to see that Arizona would move to New York for her daughter, April abruptly quit her job. However, her exit was preceded by a terrifying near-death experience that changed several other characters; the real-world knowledge that April was leaving likely convinced viewers that she was going to die.

There were a lot of emotions in the air with April’s exit and people probably questioned her decision to marry Matthew (Justin Bruening), the man she previously left at the altar. Her “happy ending” here is indeed undermined by them splitting up later. April’s exit isn’t so terrible because she is happy at that moment, even if the hopeful conclusion to her story is ruined in retrospect.

10 Dr. Jackson Avery (Jesse Williams)

Final Episode (As A Regular): Season 17, Episode 17, “Someone Saved My Life Tonight”

Although neither of them are regulars any longer, Jackson and April both continue to make guest appearances on the show, playing major roles in running the Catherine Fox Foundation. However, Jackson’s official exit from the show is well set up to complete his character arc that has been in motion since his first appearance. After years of debating how to handle the Avery legacy, Jackson decides to move to Boston to fully commit to remaking the foundation.

Jackson’s “exit” episode (season 17, episode 14) comes before his last official episode as a regular. The episode covers the emotional conversations Jackson has with his father Robert (Eric Roberts) about why he left surgery, as well as April. In the span of a single episode, Grey’s Anatomy manages to convey everything at stake for Jackson before sending him off.

9 Dr. Callie Torres (Sara Ramirez)

Final Episode: Season 12, Episode 24, “Family Affair”

The lead-up to longtime regular Callie’s exit — the oldest regular after the original cast — was a disaster of heartbreaking fights. Wanting to move to New York with her new partner, Callie and Arizona end up in a brutal custody battle for their daughter Sofia (Eva Ariel Binder). The whole thing is such a mess and bad for Callie and Arizona, let alone their daughter, that it is one of the most stressful parts of the series to watch.

Callie loses custody to Arizona and is moping around the hospital about not being able to move with Penny (Samantha Sloyan). Arizona then decides to let Callie take Sofia to New York after all. Frankly, Callie’s exit was a bit of a relief as it at least brought the terrible fights between her and Arizona to an end, and they all seemed to be at peace.

8 Denny Duquette (Jeffrey Dean Morgan)

Final Episode (As A Recurring Character): Season 2, Episode 27, “Losing My Religion”

Denny became one of the first Grey’s Anatomy patient characters with a longer storyline; after his death, he returned for a couple of episodes as Izzie’s (Katherine Heigl) hallucination caused by her tumor. The conclusion of Denny’s treatment storyline, just after receiving a new heart, is one of the earliest tragic moments now synonymous with Grey’s Anatomy. There is a certain amount of poetic drama to the whole thing due to Izzie’s efforts to save him and the hospital hosting a Prom on the night of his death.

The audience likely didn’t expect Denny to become a recurring character; patients are typically one-offs. He then stayed for many more episodes, developing an epic romance with Izzie. Just when it seemed as though he was going to make it, he died from a stroke, making for one of the series’ most upsetting moments at the time.

7 Dr. Andrew DeLuca (Giacomo Gianniotti)

Final Episode: Season 17, Episode 7, “Helplessly Hoping”

Andrew’s death also came as something of a shock because of timing; it had been a long time since Grey’s Anatomy killed off one of the young, healthy doctors. That is until Andrew is stabbed while investigating a human trafficking case, and dies in intensive care later. Andrew had become much more than fans ever expected him to be, starting out as the latest new intern.

However, Andrew and Meredith’s relationship is incredibly important to her as she figures out what she wants for herself after Derek’s death. He has several significant storylines of his own, and like most of the characters on the show, was on his way to becoming a great doctor. The suddenness of his death, his sister Carina’s (Stefania Spampinato) grief, and his appearance in Meredith’s afterlife vision made Andrew’s exit one of the saddest Grey’s Anatomy moments in a long time.

6 Dr. Alex Karev (Justin Chambers)

Final Episode: Season 16, Episode 8, “My Shot”

After discovering that his ex-wife Izzie gave birth to their twins using the embryos the couple had frozen while Izzie underwent cancer treatment, Alex decides to leave Jo (Camilla Luddington) for Izzie and the children.Alex’s controversial exit from Grey’s Anatomy is considered so because of how it constitutes a disappointing end to his and Jo’s relationship. Alex and Jo were set up to be the new Meredith and Derek, but it doesn’t end this way.

Derek’s death is heartbreaking, but the show had to kill him off, so he could remain committed to his marriage to Meredith until the end. The writers didn’t want to repeat this with Alex, but undermined his arc of the last several seasons. Alex’s exit is painful to watch because it is generally sad that he won’t be there anymore, but also because it is possibly indicative that Grey’s Anatomy has gone on for too long.

5 Dr. Cristina Yang (Sandra Oh)

Season 10, Episode 24, “Fear (Of The Unknown)”

Doubtlessly the most emotional Grey’s Anatomy exit where the character isn’t written out by killing them off, Cristina and Meredith’s final scene together was a decade in the making. Despite the end of Cristina’s story being perfect, both in terms of what she has always aspired to achieve and the quality of writing, her departure was an emotion-wracked event. Meredith and Cristina try to say goodbye to each other several times, but even they are stumbling over how to get it right.

Cristina finds a job beyond her wildest dreams which she knows she has no choice but to take. She and Meredith dance it out a final time before she says the iconic words that Meredith is the sun. The moment is triumphant and heartrending all at the same time, and Grey’s Anatomy would never be the same.

4 Dr. Mark Sloan (Eric Dane)

Final Episode (As A Regular): Season 9, Episode 2, “Remember The Time”

The episodes depicting the plane crash and its aftermath are among Grey’s Anatomy’s most gut-wrenching. Mark Sloan’s death is especially hard because he survives the crash itself, only to be left heartbroken by Lexie’s death and eventually succumb to his injuries. Mark’s death is the saddest because of all the people is leaving behind: a dedicated student in Jackson, best friends Callie and Derek, and his daughter Sofia.

The first episodes of season 9 aren’t easy and Mark’s death is possibly worse because of it. While Mark is in the hospital, so is Arizona, fighting the infection that eventually takes her leg. Yet of everything that is going on after the short time skip since the plane crash, Mark’s passing hits the hardest because fans can no longer look forward to his sardonic humor and caring moments.

3 Dr. Lexie Grey (Chyler Leigh)

Final Episode (As A Regular): Season 8, Episode 24, “Flight”

However, Lexie’s death is one of the most graphic in the series. Crushed by a piece of the plane, Lexie dies shortly after saying goodbye to Mark (having confessed her love to him only a few days or weeks earlier). Lexie and Meredith’s relationship has come a long way since their rocky beginnings and Meredith crying for her sister is heartbreaking.

After her death, Lexie and Mark return in a later season as part of Meredith’s extended dream sequence. In this scene, Lexie is just as cheerful as she was in life. Lexie is adorable but also ambitious, wanting to succeed as a doctor like everyone else in the residency program. Her death is a tragedy because her life is cut short before she can achieve everything she wants to in her career and love life.

2 Dr. George O’Malley (T. R. Knight)

Final Episode (As A Regular): Season 5, Episode 24, “Now Or Never”

The first main character death in the series is devastating, especially because it has some beats of a horrific mystery. While everyone isn’t sure where George is, Meredith realizes that the unrecognizably injured John Doe is one of her best friends in one of Grey’s Anatomy’s most terribly shocking moments. Things only spiral from there, and George is pronounced brain-dead soon after.

The tragedy of George’s death is elevated by several other factors that make the episode an emotional trial to watch. While George has recently decided to enlist and is hit by a bus when he pushes a young woman out of the way, Izzie’s life hangs in the balance in the aftermath of surgery and her continuing cancer treatment. There are almost too many things going on in this episode, making George’s exit that much worse.

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7 Things That Happen In Every Grey’s Anatomy Episode

Like any long-running show, Grey’s Anatomy has slowly fallen victim to putting the same common occurrences in each episode, even as it hits season 20.

1 Dr. Derek Shepherd (Patrick Dempsey)

Final Episode (As A Regular): Season 11, Episode 25, “You’re My Home”

However, no death in Grey’s Anatomy can match the emotional impact of Derek’s. Grey’s Anatomy season 11 puts more stress on Meredith and Derek’s marriage than ever before, making it seem like they could break up due to their conflicting career aspirations. However, Derek returns from Washington D.C. and reaffirms his commitment to Meredith, and they are blissfully content for a while.

Derek goes missing for a day before the authorities finally reach Meredith to tell her that her husband is in the hospital. Derek’s narration as the doctors botch his treatment makes “How to Save a Life” (season 11, episode 21) one of, if not the most painful moment of the series. The decade-long iconic romance comes to an end when Meredith is left widowed with two children and a third on the way. Grey’s Anatomy is known for its hurtful character exits, but few achieve the turmoil caused by Derek’s final episodes.

Grey’s Anatomy

Grey’s Anatomy is considered one of the great television shows of our time, winning several awards and four Emmys. The high-intensity medical drama follows Meredith Grey and the team of doctors at Grey Sloan Memorial, who are faced with life-or-death decisions on a daily basis. They seek comfort from one another, and, at times, more than just friendship. Together they discover that neither medicine nor relationships can be defined in black and white.

Cast

Kelly McCreary , Patrick Dempsey , Kevin McKidd , Chandra Wilson , Jesse Williams , Jake Borelli , camilla luddington , Ellen Pompeo , Chyler Leigh , Eric Dane , Caterina Scorsone , Giacomo Gianniotti , Anthony Hill , Kate Walsh , Justin Chambers , Sarah Drew , Greg Germann , Martin Henderson , Katherine Heigl , T.R. Knight , Sara Ramirez , Jerrika Hinton , Richard Flood , Sandra Oh , Kim Raver , Jason George , Tessa Ferrer , Isaiah Washington , James Pickens Jr. , Gaius Charles , Chris Carmack , Brooke Smith , Jessica Capshaw

Release Date

March 27, 2005

Seasons

20

Writers

Shonda Rhimes , Julie Wong , Jen Klein , Tameson Duffy , Meg Marinis

Creator(s)

Shonda Rhimes