Abstract Background This study sought to determine whether early referral from the emergency department (ED) would increase the number of organ donors and the number of organs transplanted per donor. Methods Retrospective cohort analysis of all patients referred to a single organ procurement organization over 60 months. Results Patients referred for organ donation evaluation from the ED were more likely to become organ donors than patients referred from the ICU (19.3% vs. 5.2%, p<0.001). ED referrals had a greater number of organs transplanted per donor than those referred from the ICU (mean 3.79 vs. 3.16, p=0.024), even after adjusting for the higher proportion of ED referrals that were trauma patients (p=0.001). Conclusions Referral for organ donation from the ED is associated with an increased likelihood of organ recovery and with an increased number of organs transplanted per donor.