Objective: To analyze clinical characteristics and prognostic factors of adult patients with multiple organ dysfunction syndrome (MODS) in emergency department. Methods: A total of 86 adult patients with MODS admitted to the emergency department from April 2018 to April 2020 were included. The clinical characteristics and the mortality in 28 days after admission were retrospectively studied, and the prognostic factors were analyzed. Results: In this group, there were many patients with severe pneumonia (24.42%) and severe pancreatitis (17.44%), and 47.67% of the patients had more than 3 organ systems involved. The main characteristics at admission of the patients were metabolic acidosis and target organ damages such as injuries of heart, liver, kidney and coagulation system. Within 28 days after admission, 29 patients died, with the mortality of 33.72%. The number of organs or systems involved, the Acute Physiology and Chronic Health Evaluation II (APACHE II), the alanine aminotransferase (ALT) level, the lactic acid (LAC) level and the N-terminal pro brain natriuretic peptide (NT-proBNP) level were correlated with the death within 28 days after admission of adult patients with MODS (P<0.05). Conclusion: The adult patients with MODS in emergency department have specific clinical characteristics, and their prognosis is related to many factors. Clinicians should closely observe and monitor the physiological status, liver function indexes, acidosis degree and related target organ damage indexes, and should timely manage tissue hypoperfusion and hypoxia. Clinicians should also monitor target organ damage indicators, do a good job in important organ function support, and strive to reduce the number of organs involved, with an aim to improve the prognosis of patients.