Top 10 Most Heartbreaking Grey's Anatomy Moments

It was both surprising and sad to see April, a devout Christian since her debut in season 6, questioning her beliefs during season 14. In perhaps an instance of divine intervention, April was given a bittersweet gift when she cared for a special patient, Rabbi Eli. In great pain, on his deathbed, Eli continued his life’s work and selflessly spoke with the struggling doctor to rebuild her faith, which was shaken by the daily tragedies of Grey Sloan Memorial. By this point, we were already crying, but what really broke us was Eli’s very last moment, when he mistook April for his wife. She tearfully played the part, providing the kind rabbi reassurance and comfort as he met his end.

It’s often said that there is no greater loss than the loss of a child. Matt Smithson, parent to 6-year-old, terminally ill Jessica, would agree. Despite a warning that Jessica’s passing was imminent, Matt continued a desperate search for treatments that would cure his dying daughter. But once Dr. Bailey realized that the young girl’s time had come, she pleaded with Matt to call off his plans. Instead, she urged him to simply be with his child. Our heartbreak intensified as we watched him finally accept his daughter’s cruel fate, followed by a joining of his little girl in her bed. As Jessica’s heart took its last beat, we sobbed almost as hard as the devastated father.

Meredith is no stranger to brushes with death. Oh, and seeing passed loved ones in a sort of limbo as she fights for her life. In season 3, she technically died and saw the late Dylan and Denny. In season 17, she found herself on death’s doorstep once again, this time after contracting the coronavirus. The severity of Meredith’s case had us panicked that this could actually be the end of the seemingly invincible Dr. Grey. That only intensified when she was reunited with Derek and George in her near-death visions. Luckily, she eventually pulled through, but her conflicting desires for eternal peace with her husband and staying alive for her kids were difficult to watch. At least MerDer finally got their proper goodbye.

Bailey’s husband, Ben, was elated to hear that his wife was pregnant, and the two were ready to raise their baby together. However, in an unfair turn of events, she had a miscarriage. Avoiding her grief, Bailey dived into her work and pushed her feelings aside, eventually leading to an emotionally charged conversation with Richard. In a powerful, vulnerable scene, the routinely strong doctor went on to express her frustrations and pain to her long-time mentor and friend. Hearing her shakily admit that she was “not fine” was absolutely crushing. Not only are Bailey and Ben easy to root for as a couple, but they truly deserved better, making the moment that much more upsetting.

Derek’s death in season 11 is a pain that stays with us throughout the series. Though a moment that added salt to this wound takes place in season 13. Meredith has a reminiscent vision that shows how she broke the harrowing news of Derek’s passing to her two kids. Trying her best to explain the situation, Meredith is met with a heart-wrenching request from her daughter, Zola – to go and “fix” her dad because that's what she does. The kids listened to their mom with gloomy looks on their faces, inducing immediate waterworks for us at home. Death is no easy thing to come to terms with for people of all ages, but it’s especially devastating when it's experienced so young.

Just as we had begun to enjoy a hiatus of losing main characters, another beloved doctor on the show was lost. Amid mental health struggles and an involuntary leave of absence, Andrew DeLuca was determined to stop a woman who he correctly suspected to be a criminal. His colleagues initially had doubts, but it didn’t matter. In a moment that had us screaming at our TV screens, an anonymous assailant stabbed DeLuca as he attempted to pursue the perpetrator. Regrettably, viewers’ high hopes of a recovery were ultimately for naught. His heroic efforts ended up saving an endangered teenage patient and many others. But we were overwhelmed with sadness when the promising, kind-hearted surgeon’s life was taken.

Alex Karev was pretty polarizing in early seasons of the show. But as the series progressed, so did our love for the peds guy who was there from day one. So when he abruptly said his goodbye in season 16, we were left with a whole slew of emotions. After finding out that his great love, Izzie, had mothered two of his children, he decided to leave Seattle and join his family. While we can understand Karev’s decision to be with his kids, the way he went about his exit was as upsetting as it was surprising. Our hearts broke for his mentors Richard and Bailey, best friend Meredith, and soon to be ex-wife Jo as they read letters revealing his shocking departure.

The finale of season 13 was, to put it simply, crazy. At the center of the mayhem was Dr. Stephanie Edwards, who was pushed to her limits as events unfolded. She fought the fight of her life as she was threatened by a predatory patient, tried to protect a child, and ran from a fiery explosion. And that’s a simplified retelling of events! Stephanie proved herself to be a hero when she escaped and saved the child, but significant damage was done, both to her body and her spirit. In her final moment on the show, she understandably made the decision to quit and live her life for herself. We couldn’t have felt worse for the suffering she endured.

By season 13, we were all well aware that when watching the show, crying is to be expected. But nothing could have prepared us for the sob-fest that ensued after Maggie’s mom, Diane, lost her battle with breast cancer. The doctor had frantically searched for treatments to prevent the inevitable, though in the end, her mother assured her that it was time to stop. Maggie proceeded to paint her mom’s nails before she drifted away, and continued to do so even once she was officially gone. The scene alone caused us great heartache. But what's more desolating is the deep void and difficult grieving period that we knew would come next for the shattered daughter. We still haven’t forgiven the show’s writers for this one.

Before we unveil our top pick, here are a few honorable mentions.

The Graduation Speech, “What a Difference a Day Makes”
Young Lives & Promising Futures Cut Short

Solidarity for Abby, “Silent All These Years”
The Women of Grey Sloan Form a Supportive Wall

Amelia Sees Her Brian Tumor, “Get Off on the Pain”
A Cruelly Ironic Revelation for the Neurosurgeon

Henry’s Passing, “Dark Was the Night”
Desperate Attempts to Save a Life Fail

Bailey Loses Her Mom to COVID-19, “Fight the Power”
Helplessness & Great Loss During an Unprecedented Health Crisis

Arguably one of the most traumatizing, chaotic season finales of the series gave us the plane crash that changed “Grey’s Anatomy” forever. While the episode is riddled with tragedy, the final interaction between Mark and Lexie hits especially hard. Stuck under debris, Lexie received a declaration of love from Mark, who detailed the beautiful life he had planned for them. The plan was ripped away by Lexie’s passing, leaving Mark, and viewers, in a painful state of grief. The moment is made even sadder by his subsequent demise in season 9. But if we’ve learned anything throughout our years watching the medical drama, it's that no amount of tragedy is too much for Shonda Rhimes.