The purpose of this study was to determine the validity and reliability of an evidence-based, emergency department (ED) fall risk assessment tool as a sensitive predictor for falls in the ED population. The overarching goal of the project was to improve patient safety and eliminate patient falls resulting in serious injury in the ED. An ED-specific tool was designed on the basis of the risk factors consistently identified in the literature: prior fall history, impaired mobility, altered mental status, altered elimination, and the use of sedative medication. The Memorial ED Fall Risk Assessment Tool was validated in two EDs (North campus and Central campus) located within a large urban health care system in Colorado Springs, Colorado. The two EDs have a combined 140,000 annual patient visits. The Memorial ED Fall Risk Assessment Tool appears to be a valid tool for this two-ED hospital system.