The objectives of this study were to determine the effect of screening examinations for depression on the care of older emergency department (ED) patients and to assess recognition of depression by emergency physicians (EPs). This was a prospective interventional study of 267 patients 70 years or older. Patients were screened for depression using the Short-Form Geriatric Depression Scale, and the results were presented to EPs after assessing EP recognition of depression. The prevalence of depression was 16.5% (44/267; 95% confidence interval, 12.0%-20.9%). Fifteen (34.1%) of 44 patients with depression were recognized by EPs as being depressed. Screening results did not alter care in any of the 44 patients with depression. No patients were given referrals or discharge instructions specifically to address depression. Depression is highly prevalent and poorly recognized in older ED patients. Use of the Short-Form Geriatric Depression Scale did not alter care of older patients with depression.