The COVID-19 pandemic has greatly affected the emergency care of older adults. Older adults (aged 65 and older) are the most likely age group to be hospitalized for and die from COVID-19.1 Specific considerations regarding the presentation and treatment of COVID-19 in older adults have previously been outlined.2 In this topic supplement, we focus on the additional ways that older adults are vulnerable to specific changes in emergency department (ED) environments that have resulted from the pandemic. Challenges in communication, crowding and boarding, and end-of-life care have been exacerbated by the COVID-19 pandemic and are likely to impact our older patients for years to come. Policies to mitigate pandemic-related challenges can promote equitable care for older adults in the ED. Recommendations herein derive from existing literature and consensus among the authors, who are experts in geriatric emergency medicine, geriatrics, and healthcare improvement.