Grey's Anatomy season 20 finale explained: Who's fired & who's pregnant?

A still from
A still from 'Grey's Anatomy' season 20 finale (Image via ABC)

ABC's medical drama Grey's Anatomy ended its season 20 with a shocking finale, aptly titled Burn It Down. Released on May 30, 2024, the tenth and final episode of the season saw nearly the entire staff of Grey Sloan Memorial Hospital get fired, along with a few other surprises.

As the acclaimed medical drama marked the conclusion of a landmark season, it set the stage for several shocking moments. The fallout from Meredith and Amelia’s secret Alzheimer’s research, using the Hospital's funds, already had severe consequences for Teddy in the previous episode. The two remaining doctors gear up to face Catherine's wrath in the finale, leaving their futures in peril.

Other characters also face their own share of problems, including a near-kiss and an unexpected pregnancy.

Disclaimer: This article contains spoilers for Grey's Anatomy season 20 episode 10.

Grey's Anatomy season 20 finale: Hospital prepares to lose most of its doctors

A still from 'Grey's Anatomy' (Image via ABC)
A still from 'Grey's Anatomy' (Image via ABC)

The tumultuous finale of Grey's Anatomy season 20, Burn It Down, sees the doctors of Grey Sloan Memorial face an onslaught of patients from a wildfire on Seattle's outskirts. Owen persuades Teddy to return and help with the emergency, despite her getting fired in the previous episode.

While chaos ensues in the ER, Catherine Fox confronts Meredith and Amelia about their secret Alzheimer’s research. Furious at their betrayal, Catherine issues an ultimatum: surrender their research to Dr. Thomas Koracick or lose their jobs. As Meredith and Amelia weigh their options, the other doctors and the surgical interns manage the influx of fire victims.

Amidst this, Lucas contemplates moving to Chicago, having received an offer from Maggie in the previous episode. As Teddy, Owen, and Bailey are en route to the OR with firefighter Theo from Station 19, they encounter a livid Catherine who tries to prevent Teddy from assisting.

Owen shouts at Catherine and she eventually allows Teddy to proceed with the life-saving surgery. For his defiance, Owen is fired by the end of the episode.

Meanwhile, Meredith and Richard have a poignant conversation about the Alzheimer’s trial. As Richard contemplates retiring from surgery, Meredith reveals to Catherine that she has published their research findings online, effectively resigning from the foundation and sealing Amelia’s and Teddy’s fates.

A still from 'Grey's Anatomy' (Image via ABC)
A still from 'Grey's Anatomy' (Image via ABC)

As the wildfire emergency subsides, the interns and residents receive their exam results, with all of them passing. Levi is disappointed to learn his scores are not sufficient for a pediatric surgery fellowship, prompting him to reconsider his future.

Surprisingly, Lucas emerges as the top scorer considering his disappointing surgeries. As he meets with Catherine to discuss his future, his classmates rally in his support and threaten to quit if he is not permitted to advance.

As Catherine counters by claiming to replace all of them, Bailey unexpectedly joins in solidarity with the interns, setting the stage for unresolved tensions to be addressed in the next season. Thus, the season 20 finale of Grey's Anatomy leaves Grey Sloan Memorial with a staff crisis.

Grey's Anatomy season 20 finale: Previous pregnancy scare turns out to be real

A still from 'Grey's Anatomy' (Image via ABC)
A still from 'Grey's Anatomy' (Image via ABC)

In episode 5 of Grey's Anatomy season 20, Jo is faced with the possibility of being pregnant with boyfriend Atticus "Link" Lincoln's child. Already parents to two kids from their previous relationships, the thought of another baby makes Jo panic and spiral out of control.

However, the pregnancy did not turn out to be real at the time. That was perhaps a foreshadowing of what was to come in the final episode of the season. While working in the NICU, Jo suddenly collapses, prompting Levi to check on her. She soon learns that she is expecting a baby.

The episode ends before she can tell Link the news. The next season is expected to explore how the couple navigates this new challenge.

Read more: 10 medical drama to watch after The Good Doctor season 7

Grey's Anatomy season 20 finale ends on a romantic note

Mika and Jules (Image via ABC)
Mika and Jules (Image via ABC)

In a tense finale, Winston performs emergency surgery on Webber’s patient, who eventually dies. He condemns Webber for allowing interns Jules and Mika to handle such a complex procedure. Jules and Mika find comfort in each other after being involved in yet another death. As Jules tries to comfort Mika, she rests their forehead together and nearly shares a kiss until Simone interrupts the two.

Meanwhile, Meredith reunites with Nick outside the hospital after resigning. Despite previously rejecting his marriage proposal, Meredith had expressed her desire for him to remain in her life.

By the episode's end, Nick agrees to be her partner, and Meredith reveals she has bought a house for them to share with her children, setting the stage for their future together.


All seasons of Grey's Anatomy are currently available to stream on Hulu.

Quick Links

App download animated image Get the free App now