Objective To explore the effect of double closed-loop management and monitoring of key performance indicators in emergency triage. Methods We performed conventional triage in emergency department from January to June 2019, and conducted double closed-loop management of triage activities and supervision from July to December 2019, including dynamic evaluation, standardized processing, real-time monitoring, continuous improvement and monitoring of key performance indicators. Results Data were collected from 4 550 patients receiving conventional triage and 4 670 receiving double closed-loop management. The accuracy rate of primary triage, the standard-reaching rate of response and the rate of patient satisfaction with triage were significantly enhanced after implementation of the double closed-loop management, whereas the rate of adverse events during waiting time was significantly reduced (P<0.05, P<0.01). The rates of complete triage information collection and secondary triage completion, as well as accuracy rate of secondary triage were gradually increased. Conclusion Double closed-loop management combining monitoring of key performance indicators effectively improve the quality and efficiency of emergency triage, enhance patient satisfaction and guarantee patient safety.