Introduction: Etomidate is a standard induction agent used during rapid sequence intubation (RSI) in the emergency department (ED). Drug shortages require healthcare professionals to utilize alternative agents such as propofol, though there is limited data to support its use. Methods: This was a retrospective chart review of adult patients in the ED who received propofol or etomidate for induction during RSI. The primary endpoint was hypotension, defined as a systolic blood pressure (SBP) <90mmHg and/or diastolic blood pressure (DBP) <60mmHg, within the first hour of administration of the induction agent. Time to intubation, intensive care unit (ICU) length of stay (LOS), hospital LOS, and in-hospital mortality were also evaluated. Results: Two hundred seventy-five patient charts were reviewed. Of the 98 patients included, 43 patients received propofol and 55 patients received etomidate. Propofol was associated with an increased incidence of hypotension within the first hour of intubation (65.1% vs. 25.5%, p<0.001). There was no difference in the time to intubation, (51.2% vs. 34.6%, p=0.83), or hospital and ICU LOS between the propofol and etomidate groups (7.7 vs. 9.2 days, p= 0.23; 4.2 vs. 6.3 days, p= 0.31). The mortality rate was 11.6% in the propofol group and 27.3% in the etomidate group (p= 0.004). Conclusions: The use of propofol compared to etomidate was safe and effective as an induction agent for RSI, however it was associated with an increased rate of hypotension within the first hour of intubation.