Climate change is the greatest public health issue of our time with emergency medicine (EM) one of the most impacted specialties as it sits on the frontline of the healthcare system. However, EM has been slow to engage despite the larger medical community working to reframe climate change as the public health issue that it is. We will explore why in this 50-minute session through the expert eyes of senior EM leadership. The session will begin with a discussion of the latest climate change and health research findings pertinent to EM through the key recommendations of the 2018 Lancet Countdown United States Policy Brief on Health and Climate Change. The two academic emergency medicine physicians, who served as the lead and senior authors of the Brief, will present these findings in an interactive fashion. They will then moderate a lively and engaging panel discussion with senior EM leadership from across the country. The panel is composed of two past Chairs, who currently serve as Vice Presidents and a Chief Operating Officer (COO) and a Chief Physician Executive, respectively, and two current Chairs. Their experience includes working at institutions directly impacted by climate-driven extreme weather such as Hurricanes Sandy and Harvey, operating in a state that is a world leader on climate action, and a perspective of climate change impacts on EM health quality and policy. There will be frank discussion around the historical and current barriers with a key focus on solutions and opportunities for our specialty, especially how to become leaders in research, administration, operations, education, and advocacy. This session is meant for any conference attendee who has ever wondered any of the following: 1.) I have been hearing more about climate change, but what does it have to do with EM?; 2.) How are my patients and EM department impacted by climate change?; 3.) Why hasn’t EM engaged more on the topic?; 4.) How can academic EM lead on the development of climate change research, administration, operations, education, and advocacy? The Lancet Countdown: Tracking Progress on Health and Climate Change is a global, interdisciplinary research initiative that monitors the world’s response to climate change and tracks health outcomes. The Lancet publishes an annual paper with an associated suite of national policy briefs that utilizes country-specific data for the most nationally relevant indicators. This Brief is acting as a collaborative and unifying platform for United States academic institutions and pertinent organizations.