Point of care (POC) testing in the Emergency Department (ED) is becoming more common. The implementation and maintenance of POC testing in the ED, however, is a complex issue. We performed a systematic review of the English language literature published between 1985 and June 2001 with a focus on POC testing and ED application. Articles that addressed the following were included in the review: implementation of POC testing, maintenance and regulation of POC testing, and application of POC testing. Current POC technology has been found to be reliable in various patient care settings, including the ED. Cost and connectivity issues are complex and difficult to assess, making these the greatest barriers to the full acceptance of POC testing in the ED. Patient care issues must be weighed against the cost of implementing POC testing and supporting the infrastructure needed to maintain this technology in the ED.