Development of smaller instruments and emergence of pediatric gastroenterology as a legitimate and growing subspecialty have been primary factors involved in effective utilization of gastrointestinal endoscopy in the care of infants and children. Endoscopic gastrointestinal procedures are now common in most major pediatric centers, and they can be safely performed on small infants, including newborns. This review of pediatric endoscopy presents many of the standard techniques that are applied in most pediatric centers in the United States. Some of the important issues and differences between pediatric and adult patients with gastrointestinal diseases are discussed.