In 2005, a large Canadian health region conducted an emergency department patient feedback survey to obtain information on patient perceptions of satisfaction with emergency services received. The Capital Health region is one of nine Alberta Health Authorities, located in the central portion of the province, serving a population of 1.6 million people in metropolitan Edmonton and the surrounding area. Analysis reveals significant demographic and acuity differences in perceptions of care and suggests the need to consider patient mix in future satisfaction surveys and to examine improvement strategies targeted at these specific patient groups.