Objective To understand the current situation of organizational silence and structural authorization a- mong emergency department nurses in tertiary Grade A hospitals，and to explore the correlation between the two factors. Methods The nurses from the emergency departments of 5 tertiary hospitals in Shanghai were selected as the research subjects by convenient sampling from January to February of 2023. A survey was conducted using the Employee Silence Questionnaire and the Work Efficiency Condition Scale，and a correlation analysis was conducted. Results The results showed that 138 nurses in the emergency department had a score of （36.72±12.56） for or- ganizational silence. Among the three dimensions，the score of tacit silence was （3.33±1.23），indifference silence was （3.06±1.19），defense silence was （2.80±1.20），and structural authorization was （61.03±13.73）. There was a negative correlation between organizational silence and structural authorization （P<0.01）. Conclusion Nurses in the emergency department of tertiary Grade A hospitals have moderate level of organizational silence，which is negative- ly correlated with structural authorization. The lower the level of structural authorization，the heavier the degree of organizational silence. This suggests that managers can reduce or even eliminate organizational silence among emer- gency department nurses by enhancing structural authorization.