Background <p>Population ageing is contributing to increasing Emergency Department (ED) attendances among older adults. Following an ED visit, this population is particularly vulnerable to adverse outcomes. Although the number of clinical trials evaluating ED-based interventions designed to improve outcomes for older adults and alleviate ED crowding is growing, recruiting older adults into such trials remains a significant challenge.</p> Methods <p>This study explored the experiences of clinical trial researchers and recruiters involved in enrolling older adults into ED-based clinical trials. A qualitative descriptive design was employed, using semi-structured interviews and reflexive thematic analysis to examine participants’ perspectives.</p> Results <p>Nine participants were interviewed, and four key themes were identified. First, participants emphasised the importance of tailoring recruitment strategies to reflect older adults’ health profiles and autonomy preferences within the ED context. Second, leveraging clinician expertise and established relationships was viewed as a key enabler of successful recruitment. Third, the dynamic and high-pressure nature of the ED environment was identified as a major barrier to engaging older adults in research. Finally, participants underscored the need for recruitment processes that are inclusive and respectful of older adults’ individual preferences and circumstances to promote equitable participation in clinical trials.</p> Conclusion <p>Stakeholders possess valuable insights into the factors that facilitate or hinder the recruitment of older adults to ED-based trials. Greater inclusivity in trial design—through more flexible eligibility criteria, consent processes, and study protocols—alongside enhanced ED resources, such as dedicated recruitment spaces, may support and sustain the participation of older adults in clinical research.</p>