We aimed to examine the case mix of adolescents presenting to an adult Emergency Department (ED) and to survey a representative sample regarding their perceived care. Of the 323 visits reviewed, 215 (66.6%) were males. Presentations increased at the weekend (151/323, 46.7%). Most visits were non-urgent, 34 (10.5%) were admitted. Acute injuries accounted for 156/215 (72.6%) of male presentations. 12/17 (70.5%) of those with a psychosocial presenting problem registered between 9 p.m. and 9 a.m. 33 adolescents presented during the prospective study period. 6 were excluded, 3 were lost to follow-up. 10/24 (41.7%) described the time they were waiting to be seen by a doctor as unacceptable, 9 (37.5%) wanted more privacy and 11 (45.9%) reported a delay in receiving treatment. Adolescents represent a minority in the ED, but have specific needs. We recommend the availability of age specific health promotion information and training of staff in adolescent healthcare issues.