1. Denny's heart failing

The only thing worse than Denny dying was when he came back for Izzy and informed her that she had cancer. I mean come on how much sadder can it get?

2. Burke leaves Christina at the altar

Christina, who never shows emotion, cries hysterically and rips herself out of her dress. This kind of response from Christina is enough to bring any audience to tears.

3. Meredith realizes the John Doe is George

None of us were expecting this. We thought George was alive and well and this ripped us all to shreds.

4. Lexie's death

Her talking to Mark about the future they are going to have, sobbing while talking about their kids; this was the worst. I ugly cried for the entire episode.

5. Christina says goodbye to Meredith

Okay so this is not that sad, but it's pretty sad. Meredith and Christina saying goodbye for the last time was a bit of a tear-jerker. They had been together since day one; they were each other's person.

6. Callie and Arizona get into a car accident

They really had to put both of them in that situation. Seriously, Shonda Rhimes?

7. Amelia realizes she has a brain tumor

Nothing is sadder than realizing the last few months of your life have been a lie because you have not been yourself.

8. Jackson and April lose their baby

A dead baby. This is just taking it to new extremes.

9. Meredith explains Derek's death to her kids

How do you tell children that their father will never come home. Cue the uncontrollable sobbing.

10. Jackson pulls a child from a burning bus

April panicking that Jackson almost died. Jackson almost dying. This messed me up.

11. Meredith almost drowning

She just gives up. Derek saves her but she was going to die. Shonda, what are you trying to do to us?

12. The doctors can only choose one patient to save

Two patients. Stuck on a pole through their abdomens. Only one of them can be saved. AND THEY MAKE THE DOCTORS CHOOSE.

13. Christina's ectopic pregnancy

Once again, Christina crying is enough to make anyone cry.

14. Meredith confessing her love to Derek

Let's be honest, we all felt what Meredith was feeling at some point.

15. Derek's death

No words. This was the worst death in TV history.