Background Patient satisfaction is an important issue in the healthcare process and plays a crucial role in measuring the effectiveness of healthcare delivery. It is of absolute importance in quality assessment activities as its comprehensive analysis can highlight noble and problematic aspects of each hospital. This study aimed to assess the emergency department (ED) patient satisfaction in a care center in Saudi Arabia and to determine the factors affecting satisfaction.

Methods In this descriptive cross-sectional study, the sample was selected from 375 patients admitted to the ED of KAMC between December 2016 to September 2017. For each patient, a validated questionnaire was filled and collected by non-random convenient sampling in two phases: August/September and December/January.

Results In total, 375 patients were entered into the study. The mean score of overall satisfaction was 57.59 (8.69) (range 19–70). The domain that had the highest excellent score was admission (171, 45.8%), while the domain that scored highest in poor satisfaction was nurses’ care (141, 37.6%). Overall satisfaction was mostly good (96, 50.8%). Those who had been hospitalized in the last 3 days prior to filling the questionnaire, and those who waited a longer time to see the doctor had significantly lower satisfaction (p=0.007 and p<0.001, respectively).

Conclusion Higher satisfaction levels were seen among patients who were treated in the main ED, admitted during morning shifts, who visited the ED during slow season (August/September), and were seen by the doctor with shorter waiting time. Patients were most satisfied with admission and least satisfied with nurses’ care. Patient satisfaction reports can complement other sources of information about quality. Further research is recommended in order to measure specific aspects of medical care and how it has been provided.