Trusts have to face a number of challenges in the provision of accident and emergency (A&E) services. One suggested way forward is to introduce the emergency nurse practitioner (ENP) role into A&E. However, this is not without controversy. Thus, this review has been undertaken in order to identify and assess any available evidence. A total of nine studies met the inclusion criteria. The studies fell into a number of categories, e.g. overall evaluation of the role, the use of radiography, and patient satisfaction. Several studies monitored transit times though A&E and there was some limited cost-benefit analysis. Overall, there was little difference found between the performances of ENPs in comparison with that of senior house officers (SHOs). The studies available for review are of poor quality, which limits the conclusions that can be made. At best, it would be reasonable to state that there is no evidence to demonstrate that ENPs are better or worse than SHOs in seeing, treating and discharging patients with minor injuries in A&E.