Casualties of a disaster flood the ER, which is short-handed because everyone is at Dr. Carter's going-away party because he's leaving the ER after 11 years. Dr. Pratt looks for the courage to confront his father, Charlie.

Much to Ray's dislike, a surrogate mother in labor doesn't want to have a C-section and endangers the life of the baby. Meanwhile, Sam tells Luka she and Alex are moving out. Pratt meets his half-brother and -sister, and Abby makes a difficult decision about a young boy.

Pratt's half-brother tries to get him to make ends meet with his estranged father. Clemente treats an infant chimpanzee and involves Abby and Neela on the secret case. Eve promotes Sam and her first tasks is to fire a beloved nurse.

Curtis Ames, a carpenter who suffered a stroke under Kovac's care, sues him for malpractice. Kovac and Ames square off in court as each man's recollections of Ames' treatment are recounted via testimony and flashbacks. Meanwhile, Abby returns to work and must adjust to the dramatic changes in her life, and Pratt's early morning trip to the barbershop results in a new awareness of community need. Also, Abby and Pratt try an unconventional method for treating a heart patient and Neela tries a risky procedure which doesn't sit well with her chief.

Kovac anxiously awaits the verdict between himself and Curtis Ames but fears the worst. Meanwhile, Neela disobeys her chief's orders and also questions her feelings for Gates, and Weaver unwittingly steals the spotlight from Morris in his big television debut.

A mysterious illness leaves little hope when a group of homeless kids enter the ER and one of them believes that Neela is a guardian angel in blue; Abby and Kovac clash over a possible case of domestic abuse; Pratt makes a shocking discovery about his brother, and Weaver is unexpectedly called into action when her television appearance becomes a real emergency.

Kovac and Gates treat a girl who appears to have been assaulted. When the police are no help with Ames, Kovac decides to confront the problem himself; Morris and other doctors work on a patient with an ice pick in his ear. Meanwhile, Ray tries to keep his new relationship a secret and Pratt can't fully deal when his half-brother officially comes out. Also, a new male nurse arrives.

Kovac and Gates deal with a hopeless father whose son succumbs to heart failure; Pratt tries to resolve the tension between him and his brother; an Armenian man tries to be a good samaritan but ends up crashing near the ER; Abby sneaks in baby Joe when she worries his sickness may be worse than it seems; Also, Sam injures the instructor of a self-defense seminar.

In 12 hours, the ER will shut down. As Kovac is under pressure to take care of the patients before the final hours, he makes a pivotal decision about his future. Meanwhile, Sam befriends a photojournalist who returns only this time she's terminally ill; Pratt is concerned when his brother ends up in the ER drunk; Morris confronts Gates when he ignores his orders and angrily sends him home while Gates tries to defend his actions.

When Baby Joe is injured by a fall at the playground and rushed to the hospital, Abby is unable to reach Luka to tell him.

Neela's short visit in Ortho turns into a game of hockey. Bettina wants to take her relationship with Pratt to the next level, but Pratt is not keen on the idea. Gates and Sam disagree over a patient. Julia provides some spiritual guidance in order to ease a prison doctor's bad conscience.

When a drunk patient is admitted to the ER, his actions endanger everyone at County. Pratt is still pursuing his dreams of becoming Chief of the ER, and Gates is worried about his future with Sam. Luka unexpectedly runs into Dr. Moretti.

The 15th and final season of ER begins with the devastating repercussions of the ambulance explosion. As Morris and Neela do everything they can to save a wounded colleague, Abby treats a young girl injured during the blast.

Chaz, now a med student, begins his ER rotation. Morris takes him under his wing and shows him some risky procedures, endangering a patient and raising Banfield's ire. Neela becomes upset when Banfield questions her authority and skills in front of her intern. Gates invites Sam and Alex to move in with him and Sarah.