20 Years of Grey’s Anatomy: 15 Behind-the-Scenes Secrets Even the Biggest Fans Don’t Know

Grey’s Anatomy has been a cultural phenomenon since it premiered 20 years ago on March 27, 2005.

The show, created by Shonda Rhimes, follows the personal and professional lives of doctors and medical staff at Grey Sloan Memorial Hospital (originally Seattle Grace). With its blend of intense surgeries, dramatic relationships plus emotional storylines, Grey’s constantly keeps viewers on their toes — just when you think the show has explored it all, Rhimes manages to introduce yet another surprising twist.

Now in its 21st season, Grey’s continues to leave quite a mark on viewers. Its original cast — which included Ellen Pompeo as Meredith Grey, Patrick Dempsey as Derek Shepherd, Sandra Oh as Cristina Yang and Justin Chambers as Alex Karev — have also become household names.

From heartbreaking deaths to romantic twists, the drama has left fans with plenty of unforgettable moments over the last 20 years.

Here’s a look at some behind-the-scenes facts from the show that have shaped Grey’s Anatomy into the beloved series it is today, 20 years after its premiere.

The show went through numerous title changes
The cast of ABC’s ‘Grey’s Anatomy’.Frank Ockenfels/Disney General Entertainment Content via Getty

Before Grey’s had the iconic name we know today, the show went through a few title changes.

According to Kate Walsh, who played Dr. Addison Montgomery, the drama initially had three different names. She shared her thoughts on the evolving titles with Buzzfeed in 2017, saying, “It was ‘Doctors’ and then ‘Surgeons’ and then ‘Complications’ and I was like, ‘What a bulls— show title!’ Grey’s Anatomy is the perfect title.”

The title not only references the lead character but also pays homage to the famous medical textbook Gray’s Anatomy.

Rhimes took inspiration from ER shows on the Discovery Channel
Sara Ramirez Callie Torres, Chandra Wilson as Miranda Bailey and Kevin McKidd as Owen Hunt in episode “Blink” of ‘Grey’s Anatomy’.Adam Taylor/Disney General Entertainment Content/Getty
Rhimes drew inspiration for Grey’s from other surgical shows, specifically those on the Discovery Channel. She explained in a 2006 interview with Oprah that she and her sisters were “obsessed with the surgery channels” and would frequently discuss the operations they saw on TV.

Rhimes realized the operating room was the perfect setting for a show, saying, “There’s something fascinating about the medical world — you see things you’d never imagine, like the fact that doctors talk about their boyfriends or their day while they’re cutting somebody open. So when ABC asked me to write another pilot, the OR seemed like the natural setting.”

Every episode is named after a song — except for one
Camilla Luddington as Joe Wilson and Matthew Morrison as Paul Stadler in ‘Grey’s Anatomy’.Richard Cartwright via Getty
One unique element of Grey’s is that nearly every episode title is named after a song.

The only exception is “1-800-799-7233,” which is the National Domestic Violence Hotline — a fitting name given the significance of this season 14 episode’s storyline.

In the episode, Dr. Jo Wilson (played by Camilla Luddington) confronts her abusive ex-husband Paul, after years of living in fear and secrecy. The episode sheds light on the impact of domestic violence and the lasting effects it can have on survivors like Jo.

It is the longest running primetime medical drama in the United States that’s still in production
Ellen Pompeo as Meredith Grey in ABC’s ‘Grey’s Anatomy’. Liliane Lathan/ABC via Getty
Grey’s holds the title of the longest-running primetime medical drama in U.S. television history, surpassing other medical shows like ER. Premiering in 2005, it has continued for more than 20 seasons and over 400 episodes, with no sign of slowing down.

The show achieved this milestone in 2019 when it aired its 332nd episode, surpassing ER as the longest-running medical drama in primetime television.

It was originally going to be set in Chicago — where Rhimes is from
Ellen Pompeo as Meredith Grey in ABC’s ‘Grey’s Anatomy’.ABC
Although Grey’s has become synonymous with Seattle, that actually wasn’t Rhimes’ original plan. She reportedly initially envisioned setting the show in a city like Boston or New York, as she wanted Grey’s to center around a “big city, big medical center, big surgical opportunities.”

Chicago was also a contender, especially since it’s Rhimes’ hometown. However, she decided against it because ER was already set there.

Ellen Pompeo didn’t actually audition for the role of Meredith
Ellen Pompeo as Meredith Grey on ABC’s ‘Grey’s Anatomy’. ABC
Pompeo didn’t go through the typical audition process to land the starring role of Meredith — in fact, she was offered the part directly by Rhimes herself. Reflecting on the opportunity with Backstage, in 2020 Pompeo shared, “Shonda Rhimes wasn’t really ‘Shonda Rhimes’ at the time. It wasn’t a big deal — it was just another pilot.”