Emergency Department triage scales can play a key role in the development of emergency care capacity for developing countries. Numerous studies exist on the reliability and validity of these systems in High Income Countries. However, little is known about the efficacy of these systems in developing countries. This systematic review protocol aims to prepare a team of international experts to investigate published literature on triage system implementation outcomes in Low and Middle Income Countries (LMICs). A systematic search will be completed from published literature, without language or date restrictions, in the following databases: EMBASE, Web of Science, Pubmed, Scopus, CINAHL, and Global Health. The search strategy for all databases include these terms: (Emergency) AND (triage). Other search terms were included, as well as a novel search string to limit to LMICs. A-priori roles, definitions, timeline and strategies are explicitly stated for this systematic review. Study protocol will be submitted to PROSPERO and the University of North Carolina Institutional Review Board. Data Abstraction forms and Quality of Evidence tables will be piloted on preliminary included studies. Study team members will review protocol for completeness. Initial search using the specified PICOTTS criteria revealed 3150 abstracts for review. Consensus from two independent reviewers will reveal full text articles to assess for eligibility. After final editing by review team, submission to PROSPERO, and approval by UNC IRB, this systematic review will resume with review of full text articles for eligibility.