These 10 Grey’s Anatomy Finales Changed Everything — #3 Still Hurts to Watch

Grey’s Anatomy is a pivotal piece of network television these days. It’s been on air for so long that it would feel strange without it. In all of its seasons, the show has gone through so many changes, whether it be cast shakeups, character dramas, or the show’s specialty: traumatic deaths.

A lot of these bigger moments happen in the season finales, and as should be expected, some of these finales are better than others. These high-stakes episodes often serve as a culmination of character arcs and storylines, leaving fans on the edge of their seats. So, which ones are the best of the best in Grey’s Anatomy’s large catalogue of episodes? Let’s rank them, shall we?

10“All of Me” (2018)

Season 14, Episode 24

The Season 14 finale kicks off pretty happily and low-key with Alex (Justin Chambers) and Jo’s (Camilla Luddington) wedding. A lot of things go wrong, but nothing too drastic or devastating, just some simple bumps, such as them getting locked in a shed, and guests arriving at the wrong location. It’s more silly shenanigans that make their ultimate wedding feel all the more romantic and perfect by the end of the episode. It also saw sparks begin to fly between Meredith (Ellen Pompeo) and DeLuca (Giacomo Gianniotti).

The reason the Season 14 finale ends up on this list, though, is because it marks the final appearances of April (Sarah Drew) and Arizona (Jessica Capshaw) as main characters. They make it out alive, which tends to be a rarity on Grey’s Anatomy, but it was still sad to see them go. April ends up reuniting with Matthew (Justin Bruening), and the pair gets married on the spot (even though she previously left him at the altar and ran off with Jackson (Jesse Williams)). And Arizona receives a text from Callie (Sara Ramirez), hinting that the pair may be reuniting when she goes to New York. It’s not the biggest finale in terms of jaw-dropping twists, but Season 14 still gave us quite a bit to talk about.

9“Didn’t We Almost Have It All” (2007)

Season 3, Episode 25

Season 3 is another finale that had a fair bit going on. In terms of major events and tragedies, the stakes were low, but there was still plenty of drama and reveals. Adele (Loretta Devine) suffers a miscarriage, which is devastating to watch. Addison (Kate Walsh) leaves to start a new life in Los Angeles and lead her own spin-off titled Private Practice. And the end of the episode marks the arrival of Lexie Grey (Chyler Leigh), Meredith’s half sister, which set into motion a whole new area of the show.

The main setting of the Season 3 finale, though, is Cristina (Sandra Oh) and Burke’s (Isaiah Washington) wedding. All season long (and really since the moment they started dating), Cristina had been trying her best to be the person Burke wanted her to be. His ideal wife. To the point where she became unrecognizable, but she loved him, so she did it regardless. So it was a huge slap in the face when Burke left her at the altar. But it allowed Cristina to take her power back and finally be the badass cardio God she always intended to be, without the show of Burke looming over her. And that moment of Meredith cutting her out of her wedding dress as Cristina sobs “I’m free”? Chills, every time.

8“Fear of the Unknown” (2014)

Season 10, Episode 24

The Season 10 finale bid adieu to one of Grey’s Anatomy’s most beloved, and longest-running characters: Cristina Yang. It was an exit that was brewing all season, but it didn’t make it any easier to say goodbye. Overall, Yang got the best send-off of any Grey’s Anatomy character. She left on her own terms for a bigger and better opportunity. There wasn’t any big tragedy or gnarly death that sealed her fate, just a final dance-it-out moment with Meredith and a tearful farewell from viewers.

The Season 10 finale is also notable for being the first introduction of Maggie (Kelly McCreary), who just so happens to be another one of Meredith’s long-lost half sisters she knew nothing about. It was a bit unbelievable and a bit hard to accept after the still-fresh loss of Lexie, but eventually Maggie grew to be a well-loved part of the series too, and a much-needed companion to Meredith.

7“Who’s Zoomin’ Who?” (2005)

Season 1, Episode 9

Season 1 of Grey’s Anatomy was relatively tame in comparison to the rest of the series, and honestly felt more like a comedy at times than the drama it became as it went on. But the Season 1 finale is the exact moment the show decided to pivot into the drama genre. After a whole season of will they or won’t they, Meredith and Derek (Patrick Dempsey) finally seemed to be ready to commit to each other no matter what their colleagues have to say about it.

Then the Season 1 finale came along, and with it one of the most memorable lines in the entire show. As Meredith and Derek are preparing to leave for the night, a woman approaches them, and Derek quickly apologizes before addressing the woman. She chides him for not answering her phone calls and then introduces herself as Addison Shepherd, and assumes Meredith to be “the woman who’s been screwing my husband.” Yep. McDreamy is married, which really brings the dreamy factor down a whole lot of notches. But it certainly amped up the drama for Season 2 and got fans excited.

6“Now or Never” (2009)

Season 5, Episode 24

Season 5 of Grey’s Anatomy was a big one because it was the first time someone other than Meredith was put at risk. Izzie (Katherine Heigl) discovers she has cancer, and it progresses throughout the season to the point where she starts preparing for the worst. She married Alex (Justin Chambers), and the pair even froze embryos together in hopes of getting a chance at a future together. In the Season 5 finale, that future looks grim, as Izzie’s health suddenly drops drastically, and she is left hanging in a sort of limbo at the end of the episode, with her fate unclear.

But on a much bigger note, the Season 5 finale said goodbye to George O’Malley (T.R. Knight) in one of the most tragic deaths in the show. A John Doe patient comes into the ER, horrifically disfigured after being hit by a bus and dragged for blocks. The man is barely clinging to life, but he musters enough strength to write on Meredith’s hand with his finger “007”, and Meredith’s cry of realization is haunting. It’s George. His nickname “007” was earned on his first day on the job. He succumbs to his injuries, giving Grey’s Anatomy its first main character death.

5“Ring of Fire” (2017)

Season 13, Episode 24

The Season 13 finale pulled a huge plot twist by writing off a character after giving them a major hero arc. That character is Stephanie Edwards (Jerrika Hinton). For most of her time on the show, Stephanie was more of a side character. Fans enjoyed her, but she didn’t get nearly as much screentime as she deserved. The Season 13 finale remedied that and gave us a huge character arc for the Grey’s Anatomy character, which was riveting and tragic, but ultimately led to her deciding to leave the hospital.

She saved a little girl from a dangerous predator who was also a patient at the time, and continued to protect her and get her out safely even after an explosion set the hospital aflame. The incident left Stephanie with horrible burns, but it’s an episode fans will never forget. It was also a memorable episode for revealing that Owen’s (Kevin McKidd) sister is alive. It’s a smaller reveal in comparison to Stephanie’s storyline, but it sets the stage for a bigger arc in the following season.

4“Perfect Storm” (2013)

Season 9, Episode 24

The superstorm is a classic example of a Grey’s Anatomy disaster episode, and it made for a great season finale in Season 9 due to just how much happened during it. For starters, Meredith goes into labor, and Shane (Gaius Charles) has to perform an emergency c-section in the dark. Luckily, both Meredith and the baby are fine, but it’s a risky procedure, and it’s nerve-wracking to watch. Jackson saves a child from a burning bus, and for a long while, the show tricks you into thinking he perished in the fire. Cristina realizes that she and Owen don’t have a future together. And to top it all off, Richard (James Pickens Jr.) gets electrocuted at the very end and his fate is left ambiguous.

But the most memorable moment to come from this finale, by a landslide, is everything to do with Callie and Arizona. Arizona sleeps with a visiting doctor named Lauren Boswell (Hilarie Burton), and Callie finds out, which naturally leads to the deterioration of Callie and Arizona’s marriage. It had been on the fritz since the plane crash and Mark’s (Eric Dane) death, but this was the final nail in the coffin and really sealed their fate.

3“Flight” (2012)

Season 8, Episode 24

The plane crash in Season 8 is one of the most memorable moments in Grey’s Anatomy history. Not only did it take the doctors out of the hospital and drop them into the middle of nowhere, but it also took out some major characters and left others with lasting impacts. Derek suffers a hand injury that nearly ends his career as a surgeon. Arizona gets a leg injury so bad that she has to get it amputated when they return home (this also leads to problems between her and Callie). And Cristina suffered from PTSD afterward and refused to speak or let anyone touch her while she was a patient.

But the most memorable moment of all is the deaths of Lexie Grey and Mark Sloan. Lexie is found pinned underneath a piece of the plane, and though they try and move it, it’s no use; she’s on the brink of death. Mark sits with her and holds her hand, professing his love to her as she takes her final breaths, and she dies, telling him they’re “meant to be.” Mark suffered less visible injuries, but they presented after Lexie passed away, and though the doctors were able to save him, he died after returning home. (Technically, he died at the beginning of Season 9, but still.) Season 8 is a finale that Grey’s Anatomy has had a hard time coming back from in terms of emotional devastation.

2“Death and All His Friends” (2010)

Season 6, Episode 24

Few episodes have shaken up a fan base as much as the hospital shooting episode in Grey’s Anatomy. After the distraught widow of a patient comes into the hospital armed and looking for Derek, he decides to take multiple casualties on his way. You don’t see it coming at first, until he approaches Reed (Nora Zehetner) and shoots her point-blank. Suddenly the entire tone of the show shifts. It’s not just a medical drama anymore; it’s a terrifying thriller. There are a lot of major injuries and casualties in this episode. For starters, Alex gets shot and is nursed back to health by Lexie and Mark. Charles Percy (Robert Baker) dies in Bailey’s (Chandra Wilson) arms, and Bailey herself is very nearly added to the body count.

Derek is eventually shot, but not fatally so, and Cristina and Jackson begin to operate on him. But then the shooter comes in and holds them at gunpoint, insisting they let him die. They manage to fake him out and save Derek, but Owen gets shot in the meantime, and Meredith suffers a miscarriage. And even after the day is saved, it’s not over, because Lexie and, specifically, Cristina, have intense PTSD from the incident. It’s a huge arc for Cristina as she very nearly quits being a doctor afterward. It’s a top-tier finale, and a memorable one at that.

1“Losing My Religion” (2006)

Season 2, Episode 27

There’s truly no other option for the number one spot other than the Season 2 finale. While so many of the show’s season finales are memorable, Season 2 is specifically one that sticks with viewers. It features the hospital prom, during which Meredith and Derek hook up despite him being with Addison. The aftermath of this decision results in Addison finding Meredith’s underwear in Derek’s coat pocket and pinning it to a corkboard for everyone in the hospital to see.

However, it’s the death of Denny Duquette (Jeffrey Dean Morgan) that really makes the Season 2 finale as memorable as it is. After an entire season of watching him and Izzie fall in love despite all the rules against it, and Izzie even cutting his LVAD wire to cheat him higher up the transplant list, Denny ultimately succumbs to his longtime heart problems. When we see Izzie again, she’s clinging to his lifeless body in a prom dress, and Alex has to physically pull her away from him. To make things even sadder, “Chasing Cars” is playing in the background, officially marking its first entrance on the soundtrack and becoming a symbol for the show. It’s a harrowing episode, but it has everything. Romance, scandal, drama, tragedy, tears, and even a little bit of comedy. It’s peak Grey’s Anatomy.