In intensive and emergency care, patients and their relatives are confronted with potentially existential crises. Spiritual care can be an additional resource to address related psychosocial and physical symptoms and to support patients and their relatives. Accordingly, healthcare workers need spiritual skills to recognize and respond to these needs. What spiritual competencies do healthcare workers in intensive and emergency care have? Are there differences between professions and genders? What factors influence spiritual competencies? The prospective questionnaire study included physicians participating in intensive care and emergency medicine courses and nurses who were training or working in intensive and emergency care. Self-reported spiritual competencies were assessed using the Spiritual Care Competence Questionnaire (SCCQ), which captures the following areas: perceptual competence, team-spirit, documentation competence, self-awareness and proactive opening, knowledge about other religions, competence in conversation techniques and proactive empowerment-competence. We included 465 physicians (50% female, years in profession: mean = 4.0, standard deviation [SD] = 3.5) and 86nurses (80% female, years in profession: mean = 12.7, SD = 10.7). The average SCC was2.3 (SD 0.4) out of amaximum of 4points, with higher spiritual competences among spiritual and religious respondents. There were differences in specific competencies between the professions and genders. Women indicated ahigher level of competence in the area of perception and conversation skills, physicians in documentation skills. Overall, there is aclear need to train healthcare staff in the field of intensive care and emergency medicine.