Background: Due to the limited treatment options available to emergency physicians to treat certain chief complaints, providers anecdotally report the perception that these patients may rate their satisfaction lower. Objectives: This study aimed to determine if patients presenting with four chief complaints with limited emergency department (ED) treatment options (abdominal pain, dental pain, low back pain, and headache) reported lower patient satisfaction scores. Methods: This is a retrospective observational study of patient satisfaction data from patients seen at a single, urban, communitybased Level I adult and pediatric trauma center with an emergency medicine residency program. As part of a performance improvement initiative, a third party vendor specializing in emergency medicine patient satisfaction assessment made up to three telephone attempts to contact each patient discharged from the ED between September 1, 2011, and March 31, 2012. Patients were administered a standardized survey assessing satisfaction with their overall ED experience. Unadjusted ordinal logistic regression was used to compare overall ED satisfaction (1=worst; 5=best) for patients presenting with abdominal pain, dental pain, low back pain, and headache against patient satisfaction scores for all other chief complaints combined. Results: During the study period, 28,021 patients were discharged from our emergency department and contacted by the survey vendor. Fifty-two percent (14,503) were reached and completed the survey. Overall patient satisfaction was distributed as follows: 5 = 61.7%; 4 = 24.5%; 3 = 9.1%; 2 = 2.5%; 1 = 2.1%. Compared to the combined group of all other chief complaints, patients with dental pain were 52% more likely to report higher satisfaction (OR=1.52; 95% CI 1.21-1.91), and patients with abdominal pain were 12% less likely to report higher satisfaction (OR 0.88; 95% CI 0.79 - 0.99). Satisfaction scores for patients with low back pain and headache were not different from satisfaction scores for the comparison group. Conclusion: In this urban community emergency department, patients experiencing abdominal pain reported lower satisfaction scores, which appears to support provider perception. However, patients with dental pain, low back pain, and headache were more or equally satisfied with the comparison group.