Healthcare is considered as one of the pivotal measure of any society towards achieving sustainability. Amongst all the integral components of a hospital or a healthcare facility, Accident & Emergency (A&E) Department acts as the main frontline support mechanism for medical care which works day and night and for seven days a week. The A&E Department becomes the main greeting/access door to any healthcare facility for the common public. It is very important that major A&E departments of hospitals in a city / urban center are optimized for current and future needs. In order to achieve this aim, it becomes necessary to evaluate the existing facilities and check for their optimum performance, their issues and procedures, document them and engage end users towards developing solutions to the existing issues to cater for their needs and satisfaction. A similar evaluation was done for Accident & Emergency department at CDA hospital (Capital hospital) in Islamabad. Major gaps were identified. As a result complete new design interventions was proposed to address the identified gaps in the A&E Department design.