Observation medicine in New Zealand has grown considerably in the last decade, driven by the shorter stays in emergency departments health target and the growth of emergency medicine as a specialty. Evidence that the growth of this service has mostly been appropriate and within suggested guidelines, is indicted by most hospitals admitting < 20% of patients to their emergency medicine governed observation unit and most subsequently admitting < 20% of these to an in-patient ward. Average lengths of stay are less than 12 hours and caseloads commonly include toxicology, low-risk chest pain and abdominal pain although the gamut of minor medical and surgical conditions are seen.