Coaching as a discipline has seen significant growth in medicine over the last decade, especially in medical education, but is at the early stages of recognition in emergency medicine. The objective of this systematic review was to provide insight into the state of coaching practice and research in emergency medicine and outline a future research agenda. Based on PRISMA guidelines, a structured electronic literature search of Embase, Scopus and EBSCOhost was conducted. Studies were included if they met all three criteria for population (‘clinicians’), concept (‘coaching’), context (‘emergency medicine’) and were published in peer-reviewed empirical studies between 2004 and 2024. Data extraction was performed by one investigator and checked for accuracy by a second investigator. A quality assessment was conducted. Of the 1441 unique articles identified in the initial search, 13 studies met the inclusion criteria. Our review revealed three key findings: coaching is examined in relation to clinician well-being and resilience, non-technical skills, and clinician technical skills, however its influence upon non-technical skills is the main focus; coaching studies are predominantly outcome studies, with process studies receiving little attention and; a range of theories and models are used in studies of coaching in emergency medicine. This review revealed that coaching research in emergency medicine is in its infancy, highly fragmented and largely disconnected from the wider coaching research literature. Nevertheless, despite the early stages of the current research base of coaching in emergency medicine, this nascent field is rich with opportunities for future research.