Background: Many patients view emergency departments (EDs) as their top choice for medical problems because they act as an easily accessible entry point into the healthcare system. The frequency of ED visits, the causes, and the burden must be considered to evaluate the quality and outcome of care. The researcher aimed to investigate the elements that affect the rate of return to the emergency department within 72 hours. In addition, to determine the underlying factors associated with unplanned ED return visits. Methods: It was a retrospective cross-sectional study.   Results: The result of this study shows that 1535 unplanned ED return visits out of 53387. The rate was 2.9%. A total of 339 (22%) patients of unplanned ED returned visits were admitted to the hospital which is representing 8% of the total hospital admission from ED. Conclusions: The study found that certain types of presenting complaints, such as fever, cough, and throat pain related to respiratory tract infection, were associated with a higher rate of unplanned return at a rate of 33% (513). The results of this study suggest that interventions aimed at improving access to follow-up care, and patient education with effective communication. In addition, continuously monitoring the rate of unplanned ED return and linking that rate to the ED physician's individual performance review might effectively reduce the rate and improve the quality and outcome of care.