Chest pain observation units are increasingly used to evaluate patients at low risk for cardiovascular events and are commonly staffed by cardiologists. The role of hospitalists in this setting has not been described. We assessed emergency department (ED) length of stay before and after adding hospitalists to the care team among 493 patients. Prior to intervention, median ED length of stay was 19.3 hours, which decreased to 11.0 hours with the addition of hospitalists (43% decrease, P <0.0001). No significant difference in 30-day cardiac event rate was observed (5% versus 6%, P = 0.68).