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**Funding Disclosure:** This project was supported by grant number R36HS027537 from the Agency for Healthcare Research and Quality, and the National Center for Advancing Translational Sciences of the National Institutes of Health under University of Florida Clinical and Translational Science Awards UL1TR000064 and UL1TR001427. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality or of the National Institutes of Health. We acknowledge the University of Florida Integrated Data Repository (IDR) and the UF Health Office of the Chief Data Officer for providing the analytic data set for this project. **Aim 1:** Develop a preliminary conceptual model of ED utilization among DHH patients through critical review of the literature. **Aim 2:** Evaluate differences in ED utilization and presentation characteristics among DHH ASL-using, DHH English-speaking, and hearing English-speaking patients using retrospective chart review. **Aim 3:** Qualitatively assess ED utilization and experience perspectives – thereby explaining quantitative results from Aim 2 – among DHH ASL-using and DHH English-speaking patients, and ED providers. **Aim 4:** Integrate findings from Aim 2 and Aim 3 using mixed methods integration techniques to revise Aim 1’s conceptual model.