20 Best Grey's Anatomy Episodes, Ranked

Since it debuted on ABC in 2005, "Grey's Anatomy" has surpassed 20 seasons and well over 400 episodes, so if you're sitting down to watch Dr. Meredith Grey's (Ellen Pompeo) journey from lowly intern to general surgery goddess, you have a lot to work through. But as with any long-running show, some episodes of Shonda Rhimes' medical drama are simply better than others. So when it comes to "Grey's Anatomy," which episodes are the best of the best?

To that end, we've compiled 20 of the very best installments of "Grey's Anatomy" right here on this list, from unexpectedly funny hours of television to some of the most heartbreaking, gut-wrenching episodes of TV you'll ever watch in your life. (Also, some of these great "Grey's Anatomy" episodes are two-parters and can't exist separately, so they share rankings here.) From stunning season finales to self-contained hours, here are the 20 best "Grey's Anatomy" episodes, ranked.

Once you've seen the ranking, drop a comment with your own favorite episodes. Which one would top your list?

This article contains discussions of sexual assault and mass violence.

Disasters are a dime a dozen on "Grey's Anatomy," but in the early days of the series, they still felt surprising and shocking — and that's definitely true of the Season 3 two-parter "Walk on Water" and "Drowning on Dry Land." When Meredith and her fellow interns Dr. George O'Malley (T.R. Knight), Dr. Isobel "Izzie" Stevens (Katherine Heigl), and Dr. Alex Karev (Justin Chambers) head to the site of a massive ferryboat crash in Seattle alongside their resident Dr. Miranda Bailey (Chandra Wilson) — leaving Meredith's best friend Dr. Cristina Yang (Sandra Oh) back at the hospital — they're overwhelmed by the scale of the disaster. Alex finds a pregnant woman trapped under wreckage and saves her life, Izzie performs emergency surgery on a man's skull using a construction worker's drill, and George desperately tries to find an injured woman's son. Meanwhile, Meredith, who's watching over a young girl, ends up thrown into the water by an erratic patient.

Ultimately, Meredith's then-boyfriend and Seattle Grace's neurosurgery chief Dr. Derek Shepherd (Patrick Dempsey) finds Meredith as she's drowning and saves her, though it's a close call — the woman is blue when he pulls her from the water. While the audience anxiously waits to hear about Meredith, her friends are completely unaware of her near-death experience. The one-two punch of "Walk on Water" and "Drowning on Dry Land" is great, even if the episode that immediately follows, "Some Kind of Miracle," veers into straight-up absurdity when Meredith finds herself in "limbo" with a bunch of dead characters.

The doctors on "Grey's Anatomy" experience more than their fair share of medical emergencies, and in the early Season 3 episode "What I Am," Meredith shows up for work with a devastating stomachache only to discover that she needs her appendix removed. This episode might seem like a light, frothy, and ultimately frivolous entry, but it's anything but. Not only is it an incredibly funny hour with Meredith, who spends most of it on morphine and ranking "all of her boyfriends" by how good they are at kissing, but there's quite a bit of plot movement in this episode. 

Dr. Mark Sloan (Eric Dane) shows up to work at Seattle Grace full time as the head of plastic surgery, driving both Derek and his soon-to-be ex-wife Addison Montgomery (Kate Walsh) insane, Dr. Preston Burke (Isaiah Washington) isn't sure his hand is ready to perform surgery again after a serious injury, and after getting rejected by Addison, Mark starts what becomes a long-running, on-again, off-again fling with orthopedic resident Dr. Callie Torres (Sara Ramirez). Beyond that, Meredith finally realizes Derek is "the one" — but is shocked when he pulls away from her after her appendectomy.

After the devastating mass shooting in Season 6 of "Grey's Anatomy" (more on that later), Cristina finds herself temporarily unable to perform surgery without suffering from severe PTSD, so when her new husband and the hospital's trauma attending, Dr. Owen Hunt (Kevin McKidd), tells her to get a job, she does. The problem? Cristina decides to start bartending at Joe's, the local bar frequented by all of the hospital's doctors ... and while Meredith and her fellow residents work an overnight shift, the attendings gather at Joe's and are horrified to see a completely inept and overly enthusiastic Cristina pouring shots for bachelor parties. (Plus, she makes a blue cocktail that she dubs the "early onset Alzheimer's" because you won't remember anything after you drink it; Derek finds it wildly offensive, and Miranda drinks several of them.)

As Cristina gets drunker and drunker while "working" behind the bar, Meredith and Alex can't get in touch with the head of pediatric surgery — not Jessica Capshaw's Dr. Arizona Robbins at this point, but Peter MacNicol's irascible Dr. Robert Stark — and perform a complex procedure by themselves. Also, Meredith's half-sister Dr. Lexie Grey (Chyler Leigh) and Mercy West transfer Dr. Jackson Avery (Jesse Williams) treat two brothers with truly devastating injuries. "Slow Night, So Long" is funny and heartbreaking; it's honestly everything that's great about "Grey's Anatomy."

Years before "The Pitt" utilized a structure where each episode takes place over one "hour," "Grey's Anatomy" did the same thing with the Season 7 episode "Golden Hour," which puts Meredith in charge of the emergency room for a night. As she says in the opening voiceover, an hour's not that long: "In medicine, though, an hour is often everything. We call it the golden hour. That magical window of time that can determine whether a patient lives or dies."

Between steamy shenanigans with Miranda and her then-fling, nurse Eli (Daniel Sunjata) and a series of patients Meredith needs to try and save in a hurry — including a dad trying to take his son to a hockey game and a guy with a "fiancée from hell" and a very serious neurological condition — "Golden Hour" is, like so many of the best episodes of "Grey's Anatomy," emotionally gutting, chaotic, and funny all at the same time, somehow. And as Meredith notes in the outro, once that difficult hour is over, the clock resets and she does the whole thing all over again.

Weddings are quite literally never a normal affair on "Grey's Anatomy" — it's like "Game of Thrones" with way less bloodshed, honestly. That's definitely true of "Get Up, Stand Up," an episode that technically centers around resident Dr. April Kepner's (Sarah Drew) wedding to EMT Matthew Taylor (Justin Bruening) but accomplishes quite a lot of other narrative stuff within its hour. 

By this point in Season 10, besties Meredith and Cristina are at odds — Meredith wants to believe that she can be a great mother and a great surgeon, and Cristina believes that Meredith is falling behind — and their furious argument during their fitting for April's bridesmaid dresses is an all-timer "Grey's Anatomy" spat. Elsewhere, Derek is fielding calls from the in-universe President of the United States (who's never named) asking him to help with a brain-mapping initiative, and Jackson is struggling with his feelings for April as her wedding approaches, even though he's ostensibly happily dating resident Dr. Stephanie Edwards (Jerrika Hinton).

Encouraged by some words of wisdom Mark gave him before he died, Jackson does, in fact, get up and stand up during April's wedding and asks her to run away with him. This, incredibly, works, leaving Stephanie and Matthew bereft, all the guests shocked, and setting up one of the show's most vital romantic relationships.

George barely gets anything to do during Season 5 of "Grey's Anatomy," which explains why actor T.R. Knight chose to leave the show after it concluded, but there's no denying that Shonda Rhimes gave him an incredibly dramatic send-off. As the original interns wait for Izzie to wake up from a risky surgery meant to remove her lingering brain tumor, Meredith and Derek struggle to find time to head to City Hall and quickly get married, and Cristina struggles with her feelings for Owen. Then, everybody finds out that George, inspired by Owen's history as an Army veteran, is enlisting as a military medic — and Miranda and several other doctors decide to hold an intervention to try and talk him out of it.

Meredith and Derek, in one of the show's most famous scenes, get married on a Post-it with vows that include "no running" and "love each other even when we hate each other." (In arguments throughout the series, they frequently invoke the Post-it.) However, everything is quickly derailed when an unidentified and grievously injured patient shows up in the ER after saving a woman and subsequently being dragged by a bus. The patient is George, and despite everyone's best efforts, he dies from his horrific injuries as Izzie has her own near-death experience. It was gutting to say goodbye to George, but this was a heck of an exit.

When Cristina's cardiac surgery mentor, Dr. Teddy Altman (Kim Raver), marries a patient, Henry Burton (Scott Foley), who needs health insurance for multiple chronic conditions, she doesn't expect to fall in love with him ... but she does, and a marriage that was originally for insurance and convenience becomes very real. Unfortunately, though, Henry needs a lot of medical care, and while he's mulling over the possibility of going to medical school late in life after some further treatments, much to Teddy's chagrin, he experiences a major health setback in Season 8's "Dark Was the Night" and is rushed to surgery. Also, while all of this is going on, Meredith and Derek learn that it's unlikely that they'll be able to adopt the baby of their dreams, Zola, and Meredith leaves in an ambulance with Alex to go pick up a newborn in need of advanced care from a small rural hospital.

Teddy, who needs to tend to another emergent patient, insists to both Owen and their colleague Dr. Richard Webber (James Pickens Jr.) that Cristina can and should do Henry's procedure, but she also insists that they not tell Cristina that it's Henry on the table. When Cristina discovers a tumor on Henry's heart, she's confused as to why Richard won't stop attempting CPR; in the scene where Owen tells her that she's just declared Henry dead, Sandra Oh does some career-best work as she comes to terms with what just happened. Add in an ambulance crash for Alex and Meredith, and you've got a pretty impactful hour.

When Izzie falls in love with cardiac patient Denny Duquette (Jeffrey Dean Morgan) in Season 2 of "Grey's Anatomy," she's subsequently devastated when he narrowly misses out on a new heart he sorely needs ... particularly because he tells her that he's signing a "do not resuscitate" order after losing said heart. Izzie, determined to fix this somehow, contacts the transplant board, UNOS, and finds out that Denny is second on the list for a transplant, and that the patient ahead of him was placed on the list just 17 seconds before Denny was, thus giving the episode its title.

As Preston Burke keeps calling Izzie and checking on his patient Denny, both doctors are aware that, if Denny's condition worsened rapidly, he'd shoot to the very top of the transplant list ... so Izzie takes matters into her own hands and cuts Denny's LVAD wire, manually pumping his heart for him as he nears death. This would be a great episode with this plotline alone, but there's also a blowout argument between Addison and Derek (over Meredith) and a conclusion where Burke finds himself in serious peril at the hands of an active shooter as he rushes to help Denny and Izzie.

Yes, this is the episode where George sort of "gives" Alex syphilis, but it also features one of the best character introductions in TV history. Throughout most of Season 1 of "Grey's Anatomy," Meredith is (somewhat) quietly dating Derek, despite their professional power imbalance. And after Miranda and Meredith's fellow interns find out and accept it, things are actually going pretty well. That's when we find out why Derek has been dodging phone calls from New York lately, and why he was so eager to move from Manhattan to Seattle.

In the episode's final moments, after we learn that George contracted syphilis from a nurse who also slept with Alex amidst a small outbreak of the STI in the hospital, Meredith and Derek prepare to leave work for the night and are confronted by a gorgeous red-haired woman in a fur coat. Derek apologizes and the woman introduces herself as Addison Montgomery-Shepherd. "Shepherd?" Meredith asks, catching on. "And you must be the woman that's screwing my husband," Addison responds, obviously referring to Derek. Iconic.

As their clinical trial to treat inoperable malignant gliomas continues to fail in Season 5, Derek and Meredith start to lose hope ... and the fate of the trial's success comes to rest on the fate of two patients with these insidious tumors who happen to be teenagers in love. Derek, who's dating a nurse named Rose (Lauren Stamile), is particularly pessimistic about how many patients have died, and without telling him or chief of surgery Richard, Meredith basically cooks the books to ensure that both Beth Monroe (Jurnee Smollett) and Jeremy West (Marshall Allman) can get the treatment. (Meredith and Derek also distract Beth's parents so the young lovers can have some... private time before the ceremony, which sounds weird but is actually really sweet.)

Jeremy doesn't make it, but using the information they learn from his surgery, Meredith and Derek still operate on Beth — and the procedure works. This brings Meredith and Derek fully back together after she proclaims her enduring love for him in a "house" made of candles on the land Derek owns, and even though he still has to end things with Rose, the golden couple fully returns in "Freedom," this stunning two-part season finale.

When Derek dies of a brain bleed after a car accident at a small rural hospital (because they don't do a head scan) in Season 11 of "Grey's Anatomy," a grieving Meredith hopes she never has to see his doctor, Penny Blake (Samantha Sloyan), again. Unfortunately, in Season 12, when Meredith hosts a dinner party in "Guess Who's Coming to Dinner," she tells Callie to go ahead and bring her new girlfriend to her home — and the girlfriend turns out to be none other than Penny herself. Not only that, but when Miranda reveals that Penny is transferring to the hospital now known as Grey Sloan Memorial, Meredith, who's been trying to stay quiet about her previous connection to Penny, goes understandably ballistic and tells everyone that Penny "killed [her] husband."

Everyone obviously freaks out over this and the party ends in disaster, but this entire hour — from an anxious Arizona drinking too much wine before meeting Penny to Alex pouring tequila down a devastated Meredith's throat — is stressful, funny, and weirdly delightful. Penny could have been a one-off character, but this was a really smart way to bring her into the fold.

After performing a game-changing abdominal wall transplant, Meredith is the clear favorite to win the prestigious (and fictional) Harper Avery Award, a recognition of surgical innovation that her own late mother, Dr. Ellis Grey (Kate Burton), managed to win twice. Still, Meredith is a physician first, and when three patients who seem like a blast from the past come into Grey Sloan Memorial in "Who Lives, Who Dies, Who Tells Your Story," she ends up skipping the ceremony in Boston and stays in Seattle to take care of two young surgical residents who got trapped in a rollercoaster car at a local fair.

Because this is the 300th episode of "Grey's Anatomy" (in the show's 14th season), the two surgeons in the rollercoaster car bear a striking and bizarre resemblance to George and Cristina — Jackie Chung's Cleo Kim and Brandon Tyler Russell's Gregory Williams — and when their pregnant friend who's also a surgical resident in their class, Liza Simmons (Eryn Rea), shows up, Meredith and Alex realize how much she looks like Izzie. As Alex helps Liza when she experiences a complication from her pregnancy and Meredith saves Gregory and Cleo, Jackson accepts Meredith's Harper Avery on her behalf while she's in the operating room — and sees a vision of a proud Ellis looking on.

The Season 15 episode of "Grey's Anatomy" titled "Silent All These Years" is one of the show's most devastating installments, but it's also one of its very best. Dr. Jo Wilson (Camilla Luddington) meets her birth mother, Vicky (Michelle Forbes), and learns that she's the product of sexual assault; this is why Vicky left a newborn Jo at a fire station, leading to years in the foster care system. Jo also takes care of a patient named Abby Redding (Khalilah Joi), who experienced her own violent sexual assault and is afraid to tell her husband, who was out of town when she was attacked.

"Silent All These Years" is undeniably straightforward and frank about the aftereffects of assault and the medical care that's required — Shonda Rhimes reportedly fought to keep a rape kit exam in the episode — and it's deeply impactful as a result. The scene where Jo asks female doctors and nurses to gather in the hallway to show love and support to Abby as she heads to surgery is one of the most enduring images of the entire show, which is pretty remarkable when you consider this happens in the 15th season.

If you or anyone you know has been a victim of sexual assault, help is available. Visit the Rape, Abuse & Incest National Network website or contact RAINN's National Helpline at 1-800-656-HOPE (4673).

"Grey's Anatomy" is a pretty episodic show and almost always focuses on season-long narrative arcs, which is precisely what makes the Season 6 episode "I Saw What I Saw" so special. When a local hotel catches fire, its guests are rushed to what's now Seattle Grace-Mercy West — there's a merge between two rival facilities earlier in the season, and the name Grey Sloan comes much later. Pretty much all of the doctors end up checking in on a woman named Cathy Becker (Erinn Hayes), who arrives in the ER with her young son. When Cathy unexpectedly experiences a blocked airway and dies shortly thereafter, Richard, the chief of surgery at the time, opens an investigation to figure out who overlooked her injuries and accidentally caused her death.

The reveal that April forgot to check Cathy's airway ends up providing the solution, marking the first of two times that April gets fired from her job on this show, but the journey to get there is fascinating. Even more notably, Meredith isn't even fully in this episode — earlier in the season, she provided a liver transplant to her father due to Ellen Pompeo's real-life pregnancy — proving that the show can be just as gripping without its leading lady.

Fans of "Grey's Anatomy" know that typically, long-running characters get killed off of the show, but thankfully, that didn't happen to Cristina Yang when Sandra Oh decided to leave the show after Season 10. In that season's finale, "Fear (Of the Unknown)," Cristina prepares to move to Zürich — in the lead-up to said finale, Cristina traveled to the Swiss capital and was offered a game-changing job by her former fiancé Burke — and leave her life behind, including her ex-husband Owen and best friend Meredith. Ultimately, the episode is a perfect send-off for this vital and incredible character.

Yes, Cristina gets her version of a fairy-tale ending — she runs a cutting-edge cardiac surgery research facility in Zürich — but the best part of her final episode is the moment she shares with Meredith before she leaves. After the best friends "dance it out," as is their custom, Cristina urges Meredith not to let Derek's ambitions outshine her own. "You are a gifted surgeon with an extraordinary mind," Cristina tells Meredith. "Don't let what he wants eclipse what you need. He's very dreamy, but he is not the sun. You are." There's truly no better way for Cristina to leave "Grey's Anatomy."

Izzie gets a heart for Denny when she cuts his LVAD wire, but not only does she put her job at risk in the process — and the jobs of her fellow interns, who protect her and won't reveal her actions to Richard and Miranda — she doesn't get her fairytale ending. After Burke is shot and rushed to Seattle Grace's ER, Derek performs surgery on his fellow surgeon, hoping he can preserve nerves in his shoulder and ensure that Burke can ever perform surgery again. Richard is hit with two personal crises: His niece Camille (Tessa Thompson) also lands in the ER after her ovarian cancer returns, and Richard's wife, Adele (Loretta Devine), reveals that she always knew about his affair with Ellis Grey, Meredith's mother.

Denny gets the heart transplant and asks Izzie to marry him on his way into the OR, but he dies of a stroke while he's recovering, leaving Izzie to discover him after she dresses up for the hospital's "prom" (an event specifically for Camille). Elsewhere, Meredith and Derek's affair begins anew after they have to put down their shared dog Doc, Izzie is discovered in Denny's hospital bed, and quits as she leaves the hospital, admitting that she cut the LVAD wire — setting the stage for many things to come.

The Season 2 episode "Into You Like a Train" picks up immediately after the previous episode ends, in which Meredith begs Derek to "pick me, choose me, love me" as he weighs whether or not to divorce Addison. As a drunken Meredith wobbles back into the hospital and is forbidden from practicing medicine until her IV kicks in, a massive train crash sends patients to Seattle Grace. Two of them need quite a lot of help — a young woman named Bonnie (Monica Keena) and a man named Tom (Bruce A. Young) were both impaled on a metal pole and survived, but now, the doctors have to figure out how to operate on them.

When the doctors determine that Tom has the better chance of survival, they're forced to abandon Monica to focus on his care, sending Meredith into a spiral, particularly because she knows, at this point, that Derek is choosing Addison. "Grey's Anatomy" is definitely knows for its disaster-focused episodes, and this one is top-tier.

After Cristina, George, and Izzie force Meredith to go to work even though she insists that she feels like she's going to die that day, a disaster strikes Seattle Grace, and it's a doozy. A paramedic named Hannah Davies (Christina Ricci) shows up with her hand shoved into a patient's body cavity, and when the doctors learn that there's unexploded ammunition — courtesy of a homemade bazooka — in his chest, the bomb squad, led by Kyle Chandler's Dylan Young, shows up.

A freaked-out Hannah ultimately flees the OR, leaving Meredith to hold the unstable ammunition steady until Burke can figure out how to operate, followed by a deeply precarious journey where the patient's bed needs to be moved away from an oxygen line. In a different part of the hospital, a heavily pregnant Miranda is refusing to give birth despite actively being in labor because her husband Tucker Jones (Cress Williams) got in a car accident rushing to the hospital and is now on Derek's OR table. From George encouraging Miranda to push to Dylan's horrible fate, the one-two punch of "It's the End of the World" and "As We Know It" is incredible.

Great TV pilots are hard to come by, but the first-ever episode of "Grey's Anatomy," titled "A Hard Day's Night," belongs in the pilot hall of fame. As she prepares for her first day as a surgical intern at Seattle Grace, Meredith has to evict a naked man from her living room floor after meeting him at a bar the night before — and when she gets to work, it turns out the guy is her boss and new head of neurosurgery, Derek Shepherd. This episode obviously introduces all of the show's original characters, but it does so beautifully; when Miranda tells her interns that she has five rules and that they should memorize them, you immediately understand who she is.

As those interns race to find a cure for a young girl named Katie Bryce (Skyler Shaye) who's having constant seizures, Meredith grapples with her connection to Derek, George almost kills a patient during a routine appendectomy and becomes an example to his peers (and earns the nickname 007, meaning he has "license to kill), and the interns struggle through a 72-hour shift. "A Hard Day's Night" is the perfect way to introduce the world of "Grey's Anatomy," and it's a genuinely phenomenal pilot.

The two-part Season 6 finale, "Sanctuary" and "Death and All His Friends," is the best installment of "Grey's Anatomy," featuring one of the best dramatic narrative arcs that has aired on network TV in recent memory. After a man named Gary Clark (Michael O'Neill) watches his wife die at Seattle Grace, he returns armed with a gun and shoots several people, including Mercy West transfers Dr. Reed Adamson (Nora Zehetner) and Dr. Charles Percy (Robert Baker), both of whom die; he also shoots Alex, Derek, and Owen, though they all ultimately survive. 

Consider for a moment that this two-part episode opens with Meredith finding out she's pregnant, only to end with her miscarrying in an operating room while believing Derek is dead. Meanwhile, Cristina and Jackson trick Gary by pulling Derek's leads off to prevent him from shooting any of them. To say it's devastating is an understatement, but this is also a stunning, stressful, and incredibly produced episode of television.

"Sanctuary" and "Death and All His Friends" manages to fit moments of levity and catharsis into these two episodes, and when they're over, you almost feel changed along with the doctors. This two-parter is the best episode of "Grey's Anatomy," and frankly, it's not even close.

"Grey's Anatomy" is streaming on Netflix and Hulu now.

If you have been impacted by incidents of mass violence, or are experiencing emotional distress related to incidents of mass violence, you can call or text Disaster Distress Helpline at 1-800-985-5990 for support.