Neutropenic fever, a common complication in cancer patients, requires prompt antibiotic treatment to prevent mortality. Current guidelines recommend antibiotic administration within 60 minutes of triage completion. However, many emergency departments (EDs) struggle to meet recommended treatment timeframes. This study in an academic medical center's ED analyzed 88 neutropenic fever cases, revealing a median time to antibiotic administration of 146 minutes, with only 7.95% meeting the 60-minute guideline. Factors like door-to-doctor time, time to antibiotic order placement, and antibiotic preparation time were found to affect time to antibiotic administration. No correlations were found between time to antibiotic administration and long-term patient outcomes in this study. Future initiatives should focus on reducing time from triage completion to antibiotic order placement to optimize patient outcomes and improve care for neutropenic fever patients in the ED.