The preference of patients for physician gender has been studied in many areas of medicine, but it has not been well evaluated in those undergoing lower GI endoscopy. This study assessed patient preference, if any, for endoscopist gender and compared the degree of preference expressed by men and women.A total of 150 consecutive patients scheduled for colonoscopy were prospectively asked to complete 2 sets of questionnaires anonymously. The preprocedure questionnaire asked whether they had a preference for an endoscopist of one gender and attempted to assess the strength of any preference by their willingness to wait until an endoscopist of the preferred gender became available. The postprocedure questionnaire assessed durability of response by asking patients who had expressed a gender preference about a possible change in their attitudes after completion of the examination.The response rate for completion of the questionnaire was 100% (80 women, 70 men). Among women, 45% (36/80) expressed a gender preference (34 for a female and 2 for a male endoscopist), whereas only 4.3% (3/70) of men expressed a preference (p < 0.001). More than 90% (32/34) of the women patients who had expressed a preprocedure gender choice said they were willing to wait until an endoscopist of the preferred gender was available. When questioned after the procedure, the attitudes of all patients who previously expressed a gender choice remained unchanged.Compared with male patients, female patients are more likely to have gender preferences for an endoscopist.