Objectives: Recent years have witnessed an increase in pediatric emergency room (ER) visits for crisis mental health care in Canada and the USA, with a high proportion driven by youth with autism spectrum disorder (ASD). This study aims to characterize the socio-demographic and clinical profiles of autistic children presenting to an ER for crisis assessment and compare them to those of neurotypical children also presenting to the ER in crisis.Methods: Twenty-five children with ASD and 286 without the disorder were compared in terms of age, sex, parent marital and socio-economic status, psychosocial functioning, suicidal behavior, psychiatric diagnosis, and reasons for ER consultation.Results: Youth with ASD showed a higher frequency of male sex (X2 (1, N = 303) = 11.97, p < .001), younger age (t(303) = − 3.08, p = .002), increased suicidal behavior (X2 (4, N = 261) = 14.99 p ≤ .005), less co-existing diagnosis of substance use disorder (X2 (1, N = 303) = 3.91 p = .048), and greater prevalence of behavioral disorders as the reason for ER consultation (X2 (1, N = 301) = 41.25 p < .00).Conclusions: An understanding of the socio-demographic and clinical profiles of the autistic population will help clinicians identify the needs of this group seeking crisis intervention, improve management, orient service delivery, increase prevention, and inform governmental organizations of the need to provide service accessibility.