Background: Emergency care is one of the most sensitive area of health care, this sensitivity is commonly based on a combination of factors such as urgency and crowding. Aim and objective: The aim of present study is to survey of emergency cases in casualty at PDU medical college and Hospital Rajkot. The objective of the study was to know the pattern of cases in the casualty and to analyze the mix pattern of emergency cases in the casualty. Material and methods: A retrospective study of all cases seen at the Casualty department of PDU Medical College and Hospital was carried out. The span of the study is from December 2015 to May 2016.A total 5555 cases of patients attending the casualty were studied from the casualty records. The data was collected from the casualty registers/records and the medical record department. To study the case mix pattern, the patients coming to the casualty were grouped under the broad speciality heading of medical, surgical and others. Results: A total of 5555 patients attended the casualty, with a Medicine: Surgical cases ratio of 3:2.The analysis revealed that highest number of patients attending casualty belonged to medicine and allied speciality Conclusion: It can be concluded that almost 50% of the patients attending the casualty department had trivial complains which did not required much attention.