Objective: To describe the incidence, characteristics and outcomes of patients with influenza-like symptoms presenting to 27 public hospital emergency departments (EDs) in Queensland, Australia. Methods: A descriptive retrospective study covering 5 years (2005-9) of historical data from 27 hospital EDs was undertaken. State-wide hospital ED Information System data were analysed. Annual comparisons between influenza and non-influenza cases were made across the southern hemisphere influenza season (June-September) each year. Results: Influenza-related presentations increased significantly over the 5 years from 3.4% in 2005 to 9.4% in 2009, reflecting a 276% relative increase. Differences over time regarding characteristics of patients with influenza-like symptoms, based on the influenza season, occurred for admission rate (decreased over time from 28% in 2005 to 18% in 2009), length of stay (decreased over time from a median of 210 min in 2005 to 164 min in 2009) and access block (increased over time from 33% to 41%). Also, every year there was a significantly (p<0.001) higher percentage of access block in the influenza cohort than in the non-influenza cohort. Conclusions: Although there was a large increase over time in influenza-related ED presentations, most patients were discharged home from the ED. Special consideration of health service delivery management (eg, establishing an 'influenza clinic border protection and public rollout of vaccination, beginning with those most at risk') for this group of patients is warranted but requires evaluation. These results may inform planning for service delivery models during the influenza season.