To create a “top-five” list for emergency medicine, Schuur and coauthors conducted a multistep project using a modified Delphi process. A technical expert panel of 9 emergency physicians reviewed tests, treatments, and disposition decisions to identify low-value items that are amenable to standardization and are actionable by emergency medicine clinicians. They surveyed 283 emergency medicine physicians, physicians’ assistants, and nurse practitioners about potential benefit or harm and actionability. The final top-five list includes 3 computed tomography examinations, 1 magnetic resonance imaging examination, and 1 blood test. An Editorial from Grady and colleagues discusses the development of top-five lists.