In this episode, 6 doctors from Seattle Grace Mercy West Hospital become victims of an aviation accident and fight to survive, but Lexie Grey (Chyler Leigh) tragically dies.

Other storylines take place in Seattle, where Richard Webber (James Pickens, Jr.) prepares for his annual dinner for the departing residents, Owen Hunt (Kevin McKidd) fires Teddy Altman (Kim Raver), and Miranda Bailey (Chandra Wilson) gets engaged to Ben Warren (Jason George).

Upon its initial airing, the episode was viewed in the United States by 11.44 million people, received a 4.1/11 Nielsen rating/share in the 18–49 demographic, ranking #4 for the night in terms of viewership, and registering as Thursday's highest-rated drama "Flight" received widespread critical acclaim from television critics and audiences alike, with high praise directed towards the performances of Leigh, Ellen Pompeo (Meredith Grey), and Eric Dane (Mark Sloan).

The episode opens with a voice-over narration from Richard Webber (James Pickens, Jr.) and Meredith Grey (Ellen Pompeo) about the challenges of residency and how success is determined by individual perseverance.

After their plane crashes in the woods, Meredith Grey (Ellen Pompeo), Derek Shepherd (Patrick Dempsey), Cristina Yang (Sandra Oh), Mark Sloan (Eric Dane), Lexie Grey (Chyler Leigh) and Arizona Robbins (Jessica Capshaw) are left desperately fighting to stay alive.

Webber prepares for the annual dinner for the departing residents, including Alex Karev (Justin Chambers), April Kepner (Sarah Drew) and Jackson Avery (Jesse Williams), who are anxious about their futures.

Owen Hunt (Kevin McKidd), the hospital's chief of surgery, makes the difficult decision to fire Teddy Altman (Kim Raver), allowing her to take the chief position at United States Army Medical Command without the guilt of leaving the hospital where her husband died.

[3] Filming took place in Big Bear Lake, California, a location previously used in Season 7 for Cristina Yang (Sandra Oh) and Derek Shepherd's (Patrick Dempsey) fishing trip.

[4] Commenting on the challenging filming conditions, Chyler Leigh (Lexie Grey) shared: "It would rain and be sunny and hot.

[8][9] In terms of overall viewership for the night, "Flight" ranked fourth, behind the season finales of Fox's American Idol, and CBS's Person of Interest and The Mentalist.

The episode's rating was second only to American Idol but managed to surpass shows like CBS's The Big Bang Theory, Person of Interest, and The Mentalist.

[9] Additionally, the episode saw a notable increase in ratings compared to the previous season's finale, "Unaccompanied Minor", which had a 3.6/9 rating/share in the same demographic.

While she appreciated the show's realism and authenticity, Lane found the episode "almost too much" due to its gory visuals and the emotional weight of the storyline, particularly praising Ellen Pompeo's performance during Meredith's reaction to Lexie's death.

He noted that Lexie's death felt like a finale in itself and found Teddy Altman's departure the most significant moment at Seattle Grace.

Stransky also criticized Arizona Robbins' (Jessica Capshaw) screams but found Miranda Bailey's (Chandra Wilson) storyline compelling.