To assess parental perception of urgency of illness and compare this with an emergency department (ED) physician's assessment of the same.A prospective study was conducted on convenience sample of parents/legal guardians of 800 patients presenting to the pediatric ED. Parents and physicians were asked to classify the urgency of their child's illness.For this study, we grouped the urgency of illness as "urgent" (care needed within 24 hours) and "nonurgent" (care could safely wait until the next day). Ninety-four percent of parents considered their child's illness as urgent and 6% as nonurgent. Of the patients whose parents perceived the illness as nonurgent, 31% were assessed by physicians as requiring urgent attention.In our study, there was a significant discrepancy between the parental perceptions of urgency of illness and the ED physician assessment of the same. A significant proportion of children whose visits are perceived as nonurgent do require urgent care.