13 Most Heartbreaking 'Grey's Anatomy' Episodes Ever

It is important to remember that the best drama series punch us all in the heart now and again. Grey’s Anatomy contains some of TV’s most gut-wrenching, heartbreaking moments ever, and those moments have made viewers hate creator Shonda Rhimes at times. Yet, fans keep going back for more. After all, the show is finishing up its 12th season. Here are 13 Grey’s Anatomy episodes that had everyone reaching for tissues. 

*This contains major spoilers. 

01
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'Flight' - Season 8, Episode 24

The Plane Crash
Photo credit: ABC

In this episode, a team of Seattle Grace surgeons flies to another hospital to help with a surgery involving conjoined twins, but their plane crashes before they get there. Every doctor gets injured somehow, but Lexie Grey loses her life. Her last words contain two confessions: she was always proud to be Meredith's sister and she was completely in love with Sloan. And if she would have survived, they would have finally been together. 

02
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'How to Save a Life' - Season 11, Episode 21

Derek Shepherd
Photo credit: ABC

Losing Derek “McDreamy” Shepherd (Patrick Dempsey) from the Grey’s Anatomy cast crushed the hearts of MerDer fans everywhere. However, showrunner Shonda Rhimes said that with Patrick Dempsey leaving the show, she didn’t have a choice. The couple spent 11 years falling and being in love, so she did not want to take away from that.

In this episode, Derek witnesses a car accident on his way to Washington, D.C. and jumps in to make sure everyone is safe. Once he gets things under control, he reaches under his seat cushion for his phone, makes a three point turn and is T-boned by a mack truck. 

Derek was taken to a random hospital (not Seattle Grace) with doctors who conveniently forgot to take him for a head CT, resulting in his death. Coincidentally, it was a brain injury that took the neurosurgeon's life. If it wasn't already the hardest moment in Grey's history, Shonda Rhimes took it a step further. Instead of letting him die on the table, she decided he'd go brain dead and Meredith (Ellen Pompeo) would be the one to pull the plug with "Chasing Cars" playing in the back ground. Talk about tragic. 

03
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'Going Going Gone' - Season 9, Episode 1

Mark 'McSteamy' Sloan
Photo credit: ABC

No Grey’s event ripped out more hearts than the plane crash in the Season 8 finale. This episode takes viewers back to the scene and in the hospital afterward. Although several sad moments happen in this episode, nothing comes close to Mark "McSteamy" Sloan's death. Fans knew that he was going to die before the episode started, so they did see it coming. What made it more of an emotional roller coaster was that Sloan was telling everyone Lexie was waiting for him, leading to a montage of moments that prove she was always the one. 

04
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'Walk on Water'/'Drowning on Dry Land' - Season 3, Episode 15/16 or 17

Grey's Anatomy
Photo credit: ABC

​ A ferry crash brings all of Seattle Grace to the scene. As several doctors are trying to save hundreds stuck under rubble and as Meredith tries to examine a little girl, she falls into the freezing water. Many doctors walk by her in the water, but they don't know she's in there. Eventually Derek finds her and carries her blue and lifeless body out of the water. The incident leaves people unsure if Meredith really had trouble swimming or if she didn't want to be saved. Although everyone knew Meredith wouldn't die, it was the first huge event in Grey's history. And it showed just how much one person's presence can have on a group of people. 

05
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'Now or Never' - Season 5, Episode 24

George O'Malley
Photo credit: ABC

It is hard to lose any major character in a series, but losing the lovable George O’Malley was extremely difficult for fans. He was hit by a bus, which caused injuries that left him unrecognizable. It wasn’t until he wrote “007” on Meredith’s wrist that everyone figured out it was George. What made his exit so devastating was that he didn’t really get to say goodbye. 

06
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'Freedom - Part 2' - Season 4, Episode 17

Rebecca Pope and Alex Karev
Photo credit: ABC

After a huge ferry crash, Alex spent weeks being Rebecca's doctor. The crash gave her amnesia, so they called her Ava. Ava and Alex became very close, but when her memory returned, Alex told her to go back to her husband and child. She decides to come back to Alex, but she still isn't who he thought she was. She suffers from bipolar disorder, and she attempts to commit suicide. At that moment, Alex knows they can't be together. This is the most human and kind Alex has seemed up to this point, so it's devastating to see him lose his happy ending. 

07
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'The Other Side of This Life: Part 2' - Season 3, Episode 23

Thatcher Grey
Photo credit: ABC

Throughout the third season, Meredith got closer to her father Thatcher and her stepmother Susan. When Susan came into Seattle Grace with the hiccups, they thought it would be no big deal. However, Susan has a rare complication that causes her to die on the table on Meredith's watch. In one of Grey's most intense scenes, Thatcher slaps his daughter across the face, blaming her for Susan's death, and Meredith loses the chance to be close to her father forever. 

08
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'Didn't We Almost Have it All?' - Season 3, Episode 25

Cristina Yang
Photo credit: ABC

It is Burke and Cristina's wedding day and all seems to be going well. Burke gets out of surgery just in time and Cristina gets over her doubts. She has a minor cold feet incident before she is about to walk down the aisle, and Burke comes to check on her. Cristina says she's ready, but Burke says he loves the woman he's been trying to make her be or the woman he thinks she'll become instead of the woman she is now.

If this wasn't hard enough to watch, Meredith meets Cristina back at her apartment, where she is standing in her wedding dress. She starts having a panic attack and Meredith cuts her out of her dress, leaving everyone heartbroken for Cristina. What makes this one so tough on fans is that Burke and Cristina had a rough ride; they lost a baby and survived a gunshot wound. Their wedding was supposed to be one of the most romantic moments on the show. 

09
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'Fear (of the Unknown)' - Season 10, Episode 24

Cristina leaves 'Grey's Anatomy'
Photo credit: ABC

Although Cristina has tried to put off her move to Zurich several times, it finally happens here. Of course, this goes on the list of heartbreaking episodes due to the tearful goodbyes, but it also marks the end of arguably the strongest relationship on the show, its heart.

In this episode, Cristina tells Meredith that she is "the sun" and that she shouldn't let anyone shadow her, while Meredith returns with similar encouragement. And in their final moments together, they dance it out. Cue the tissues. 

10
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'Losing My Religion' - Season 2, Episode 27

Izzie loses Denny
Photo credit: ABC

Izzie (Katherine Heigl) risks her career to move Denny Duquette (Jeffrey Dean Morgan) up on the heart transplant list, but when he ends up getting the heart, his body rejects it and he dies. Izzie spent most of season 2 falling for Denny, so when viewers see Izzie lying on the floor in the bathroom wishing he would return, they understand. And they’re probably in tears. 

11
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'Dark Was the Night' - Season 8, Episode 9

Teddy loses Henry
Photo credit: ABC

Cristina operates on Teddy’s husband Henry (Scott Foley), who has chronic health issues, after he starts coughing up blood. However, he dies on the table. Teddy (Kim Raver) really should have been the one operating on Henry based on her skill level, but she had to take another case at the time and operating on her own husband would be too hard. So she chose Cristina. They keep the name of the patient from Cristina so she won't be nervous; as a result, she is overly cocky. Would he still be alive if she had known it was Henry? Would she have been more careful? 

12
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'All I Could Do Was Cry' - Season 11, Episode 11

April and Jackson Avery lose their baby
Photo credit: ABC

The episode's title says it all. April (Sarah Drew) and Jackson (Jesse Williams) find out that their baby has brittle bones, but they decide to give birth to him anyway. They even go so far as to give him a name, Samuel, but he dies in April's arms a few minutes after he is born. All April wanted was to start a family with Jackson, and she was so close. Plus, so many people wanted it for them. 

13
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'Sanctuary' - Season 6, Episode 23

Derek Shepherd gets shot
Photo credit: ABC

This is the first time fans almost lose Derek. In this episode, an enraged widower decides to get even with the doctors he thinks killed his wife. He's willing to shoot just about anyone, but he's after Derek and the Chief. At the end of the episode, the man shoots Derek while Meredith is watching from afar. Not only did Meredith have to watch him get shot, but she doesn't know if he'll survive. Plus, she found out that she was pregnant, and because Shonda Rhimes can't give anyone a happy ending too soon, she loses the baby. At least Derek survives.