Objective. The aim of this study was to compare emergency department (ED) key performance indicators for patients presenting with low back pain and seen by an advanced musculoskeletal physiotherapist (AMP) with those seen by other non-AMP clinicians (ED doctors and nurse practitioners). Methods. A retrospective audit (October 2012-September 2013) was performed of data from three metropolitan public hospital EDs to compare patients with low back pain seen by AMP and non-AMP clinicians. Outcome measures included ED length of stay, ED wait time, admission rates and re-presentation to the ED. Results. One thousand and eighty-nine patients with low back pain were seen during AMP service hours (360 in the AMP group, 729 in the non-AMP group). Patients seen by the AMP had a significantly shorter ED wait time (median 13 vs 32 min; P < 0.001) and ED length of stay (median 141 vs 175 min; P < 0.001). Significantly fewer patients seen by the AMP were admitted (P < 0.001), and this difference remained after accounting for the difference in triage code between the groups. Conclusions. Improved ED metrics were demonstrated in patients with low back pain when managed by an AMP compared with patients seen by doctors and nurse practitioners.