Gastroscopy has become a safe and reliable procedure following the development of modern fibreoptic instruments which have replaced the semi-flexible gastroscope. Indications for gastroscopy may be diagnostic (to elucidate the nature of definite or indefinite radiological abnormalities, in persistent X-ray negative dyspepsia, post gastric surgery symptoms and upper gastrointestinal bleeding) or therapeutic (including polypectomy, electrocoagulation of bleeding points, papillotomy and removal of retained stones and the use of a laser beam to control bleeding). In can be done as an outpatient procedure with a low incidence of complications in experienced hands, but should be performed only in a properly equipped area with resuscitation facilities. Gastroscopy should form part of the routine investigation of patients with upper gastrointestinal problems where the appropriate indications are present.