Objectives <p>Emergency departments (EDs) increasingly serve patients with complex social needs alongside medical concerns. Social workers are vital interprofessional team members whom&#xa0;address these needs, though their role varies significantly across institutions. This scoping review explores the role of social work in adult emergency departments as described in current literature.</p> Methods <p>Following Joanna Briggs Institute guidelines and PRISMA-ScR reporting standards, we conducted a comprehensive literature search across MEDLINE, PsycINFO, Scopus, and CINAHL, focusing on English-language articles published since 2004 that describe social workers’ direct patient care roles in hospital adult EDs.</p> Results <p>Twenty-seven articles met the inclusion criteria, representing diverse geographical contexts and methodologies. Social work roles were clustered into six themes: connecting to community resources (<i>n</i> = 13), reducing hospital use and admission (<i>n</i> = 6), psychosocial assessment and support (<i>n</i> = 6), guiding patients through serious illness (<i>n</i> = 5), disposition and safe discharge planning (<i>n</i> = 4), care planning and case management (<i>n</i> = 4). When reported, staffing models included weekday coverage (<i>n</i> = 2), extended hours (<i>n</i> = 5), and 24/7 coverage (<i>n</i> = 5).</p> Conclusion <p>Social workers fulfill diverse roles in EDs, primarily focused on referrals to community resources, reducing hospital utilization, providing psychosocial support, and guiding patients through serious illness. Significant variation exists in implementation, staffing, and utilization of social work&#xa0;across institutions.&#xa0;EDs should consider involving social work directly with critically ill patients, as well as&#xa0;supporting the improvement and development of&#xa0;relationships with community services.</p>