The Grey’s Anatomy season 20 premiere continues the show’s new era to great effect. Last season, Grey’s successfully navigated star Ellen Pompeo’s reduced role, with Meredith Grey only appearing in eight of the season’s 20 episodes. The show also introduced a new batch of interns: Simone Griffith (Alexis Floyd), Benson “Blue” Kwan (Harry Shum Jr.), Jules Millin (Adelaide Kane), Mika Yasuda (Midori Francis), and Lucas Adams (Niko Terho). With a focus on the new class, season 19 was praised for its return to the show’s roots, with plenty of nostalgic references to its first season, which aired back in 2005.

Season 20, which has a new showrunner in Grey’s veteran Meg Marinis, largely follows suit in the premiere. Coming out of the last season, the interns found themselves in varying degrees of trouble, with Simone, Mika, and Lucas involved in an unsupervised surgery and Blue ignoring a DNR from Jules’ roommate, Max. The fallout from that drives much of the premiere, and the intern dynamics remain very familiar for those who have watched Grey’s since the beginning. There’s a lot of bickering as they scramble to save their jobs and time devoted to the romantic developments between Simone/Lucas and Blue/Jules.

Grey’s Anatomy Season 20 Doesn’t Forget Its Classic Characters

While the interns are a focus, the legacy characters get their due, too. The in-story reason for Meredith’s visit to Seattle is perhaps a little flimsy this time around, but it’s smart to include Pompeo in the premiere. She’ll appear in at least four of Grey’s Anatomy season 20’s ten episodes and, as always, plays a key role in setting the show’s tone.

Meredith teams up with Bailey for much of the premiere, which contributes to its nostalgic feel. Their banter about Mer’s time as an intern is a standout, and the episode concludes with a neat reference to the show’s early days. A fairly big change in Meredith’s relationship with Nick (Scott Speedman) is welcome, too, especially considering their back-and-forth last season. There’s also time to check in with other longtime characters like Jo (Camilla Luddington) and Link (Chris Carmack), who are coming off their big confessions in the season 19 finale.

The rest of the premiere is understandably devoted to Teddy (Kim Raver) following her collapse in the OR. As expected, Kevin McKidd’s Owen gets a lot to do in this storyline, and wisely, so does Amelia (Caterina Scorsone). Owen and Amelia’s romantic relationship could be ugly at times, but season 19 did a good job establishing them as supportive friends, and that dynamic really shines in this episode.

Of course, the premiere’s biggest draw is the simple thrill of being with the characters again after the longest break between seasons in the show’s history – the season 19 finale aired in May 2023. This extended time away earns the premiere a lot of goodwill, but if there’s one complaint, it’s that the show plays it a bit safe with its return. There are a couple of moderately surprising moments but nothing truly shocking. This is a little disappointing as, in theory, the long hiatus provided an opportunity for some major developments.

The Grey’s Anatomy Premiere Sets Up Some Exciting Storylines

However, the vast majority of the episode is effective as is. It covers a lot of ground, and the choice to pick up just moments after the season 19 finale winds up working fairly well. The episode moves at a brisk pace and sets up some interesting developments for the rest of the season.

One of those is a smart storyline for Meredith that can easily simmer away in the background, being brought out as Pompeo’s availability allows. In short, the episode functions as a good premiere should; it’s plenty interesting on its own but even more exciting when thinking about the possibilities for the rest of Grey’s Anatomy season 20.