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Objective To assess the patient satisfaction in emergency unit by evaluating the healthcare delivery system, attitude and behavior of healthcare givers and extent of available health facilities. Methods A cross sectional descriptive study was conducted among 500 study subjects who came to emergency department of District Head Quarters Hospital, Rawalpindi during a period of two weeks in September 2009. The respondents were enrolled in the study by convenience sampling. The study participants included those patients who received treatment and were about to be discharged or shifted to wards or referred to any other healthcare center. Data was gathered by using interviewer administered questionnaire. Results Of the 500 subjects, 54.5% respondents were patients while 45.5% respondents were their attendants. Majority (33.15%) presented to emergency department with accident related injury. 23.3% respondents had to wait for more than 5 minutes at reception for getting emergency ticket. 38.76% faced difficulty in getting the wheel chair and stretcher. 76.9% had their first contact with doctor in emergency unit while 19.1% and 3.93% were firstly received by nurses and paramedics respectively. 16.38% had to wait for more than 30 minutes for consultation with healthcare providers after getting an emergency ticket. 64.97% were asked for investigations and among those investigations, 60.67% were done in hospital. According to 29.5% respondents, more than 1 hour was spent in getting the report of investigations. 45.51% were partially treated out of which 43.26% brought their medicines from outside. 51.69% stayed in emergency unit for more than 2 hours. 68.54% were satisfied with explanation of the health problems by healthcare givers. 61.8% were fully satisfied with the management while attitude and behavior of doctors, nurses and paramedics were found to be satisfactory by 95.5%, 94.5% and 93.3% respondents respectively. Drinking water was not available to 52.25% respondents. 69.6% were satisfied with seating arrangements. 60.11% had to use their own mobile phone for conversation while telephone facility in emergency department was available to only 15.17%. Conclusion Attitude and behavior of healthcare providers were found to be satisfactory by the respondents. However, some basic requirements in emergency department of the hospital like availability of telephone, provision of safe drinking water and general sanitary conditions need to be fulfilled. (Rawal Med J 2010;35: ).