Derek dies in Greys Anatomy season 11 episode 21 titled "How to Save a Life". In this episode, Derek is involved in a car crash and is rushed to the hospital. Despite his conscious state, he is unable to speak and tries to communicate with the doctors through his thoughts. He knows he needs a CT scan, but the doctor in charge focuses instead on his internal bleeding. By the time the doctors realize he needs a CT scan, its too late, and he is declared brain dead. Meredith Gray, his wife, signs the papers for Derek to be taken off life support and sits by his side as he passes away.