We will review the findings of a systematic review related to health disparities in the care of youth with aggression in the Emergency Department (ED), including referral, assessment, diagnosis, use of pharmacologic interventions, and utilization of restraint and seclusion. This study used the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 checklist searching PubMed and PsycINFO databases (May 1, 2013-May 5, 2023) for studies that reported disparities in the care of youth with aggression in the Pediatric ED. Disparities in the care of youth with aggression in the ED exist for race, sex, age, developmental status, and insurance status. Although there are disparities in the care of youth with aggression in the ED setting, further research is needed to better understand the impact of health disparities, the factors contributing to these inequities, as well as tangible solutions to improve systems of care to mitigate these disparities. Suggested steps to address mental health disparities in the pediatric ED are discussed.