Although homelessness is a societal problem across the US, 60% of people experiencing homelessness are located in urban centers. Structural factors such as lack of affordable housing are the central drivers of urban homelessness, rather than migration patterns or individual characteristics such as substance use and mental illness. Unhoused individuals have a larger burden of disease compared to the general population, with higher mortality rates even when controlling for other factors. Although emergency departments provide access to some of the lowest barrier health care in urban areas, unhoused patients are more susceptible to deviations from the standard of care. Clinicians risk making biased or uninformed triage and treatment decisions for this patient population, which creates the potential for poor clinical outcomes. Emergency clinicians should treat people experiencing homelessness with respect and provide an appropriate evaluation and disposition as determined by presenting complaint as well as associated health and social needs. In addition to clinical care, EDs can provide people experiencing homelessness with connection to support services to improve health outcomes.