This document summarizes a case study of installing 48 E1 ports on a single Elastix system. It describes the challenges of supporting high concurrent call density on Asterisk/Elastix and how they were addressed. Hardware included 12 OpenVox D430 cards supporting 1488 channels total. Software configuration increased file limits and loaded the driver. Testing involved Winsip calls across the E1 spans with CPU loads up to 580%. The large installation demonstrated Elastix's ability to handle high density VoIP. The future may require more powerful E1 gateway and Asterisk products to meet growing market demands.