Violence in the emergency department (ED) setting is well documented in the medical literature. Injuries to ED personnel and other patients are also not infrequent. Weapons brought into the ED by patients can be used to cause significant injury to others. To address increased staff concerns for their safety, a formal security screening process was initiated at our urban based ED. We sought to assess the impact that this weapons screening process had on the identification and removal of weapons. This is a before-after study methodology to evaluate the impact of the initiation of a formal weapons screening program in an urban Level 1 trauma center ED (annual census approximately 45, 000 visits/yr). On March 15, 2021, a formal security screening process was initiated for entry to the ED, and signage was placed to notify the public and allow individuals to leave any potential weapons outside the hospital. Prior to this time, only psychiatric patients in the ED were screened for any weapons. The new security screening included limiting ambulatory ED public access to a single-entry site where all patients and visitors were screened using a walk-through magnetometer or wand metal detector, and all bags were visually inspected. For patients arriving by ambulance, security officers performed a bedside screening and baggage check. Part of the new process is that there is a restriction to one personal item allowed in the ED with the rest of bags/belongings being secured and stored and not allowed to enter into the ED. Data were collected for the 8 weeks prior to the new screening process (Pre-Screen period, 1/18-3/14/2021) and 8 weeks after initiating the new screening (Post-Screen period, 3/15-5/9/2021). Time periods were compared with specific measurements including total number of individuals screened and weapons confiscated. Descriptive statistics, including p-values for comparisons, are reported. The 8-week Pre-Screen and Post-Screen periods were similar in terms of total ED census (6, 570 vs 7, 103 visits, respectively) and psychiatric patients cared for (511 vs 487 patient visits, respectively). Prior to the new screening process, 511 psychiatric patients were screened with 15 weapons confiscated. After the screening process was initiated, 13,149 total screens were performed on ED patients and visitors during the 8 week period with 194 weapons found and confiscated. Overall, persons screened increased by 25 fold with a significantly lower rate of weapons identified per screen (2.9% vs 1.4% positive weapons per screening) by expanding screens to all patients and including visitors (p=008). More importantly, the number of weapons identified and confiscated prior to ED entry increased 13 fold, from 0.26 weapons/day in the Pre-Screen period to 3.46 weapons/day in the Post-Screen period (<0.001). Implementation of weapons screening significantly increased the number of weapons identified and confiscated prior to entry in the ED by patients and visitors. Future research should focus on how such screening processes impacts ED flow and overall safety, as well as ED staff, patient and visitor perception of safety and satisfaction.