This qualitative grounded theory study explores the role of mnemonic acronyms in clinical emergency medicine to inform educational leaders who use mnemonic acronyms with increasing frequency in educational programs. An electronically deployed survey on mnemonic acronyms provided foundational data which was enhanced by an analysis of data from surveys and participant diaries. A grounded theory of mnemonic acronym use including the frequency of use, usage patterns, mnemonic acronym types, and the lifespan of mnemonic acronyms led to a series of recommendations for educational leaders, educators, and learners. Approximately 20% of learners do not employ mnemonic acronyms, 60% use only a few, and 20% frequently use mnemonic acronyms. Educational leaders should avoid building medical education programs around mnemonic acronyms, requiring their use, or including mnemonic acronyms in evaluation tools.