It has been identified that ineffective nurse-patient communication in the emergency department can lead to frustration, mistrust and inadequate pain management. Therefore, it is important to recognise the potential barriers to effective communication, including nurse and patient-related factors. To identify what emergency nurses perceive as barriers to nurse-patient communication, and if there is any difference in the perception of communication barriers between nurses' demographic subgroups. A total of 199 emergency nurses were recruited using convenience sampling, from nine hospitals in the West Bank, Palestine. These nurses completed a 27-item questionnaire that encompassed six domains of barriers that may affect nurse-patient communication: demographic, knowledge-related, environmental, social, economic and psychological factors. Of the six domains covered by the questionnaire, environmental factors scored the highest, meaning that emergency nurses perceived these to be the most significant barriers to effective nurse-patient communication. This was followed by knowledge-related and psychological factors. Knowledge-related factors were perceived to be a greater communication barrier by male nurses more than female nurses, and by younger nurses more than older nurses. To enhance nurse-patient communication, it is important to establish a comfortable working environment and to provide ongoing training for nurses to develop their communication skills. ©2020 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.