Objective: The Objectives of the study were to observe the different endoscopic findings and to enumerate complications associated with the procedure. Design: Retrospective Cross Sectional study. Place and Duration of Study: The venue of the procedure was Endoscopic unit of Pediatrics Unit of Civil Hospital Karachi from January 1998 till September 2009. Materials & Methods: 991 gross endoscopic findings and biopsies were retrospectively analyzed from record. After taking consent history and examination of all patients were recorded on a performa. Fasting for 4-8 hours depending on age was a prerequisite and other steps were a good Hb level and I/V cannula placement. Results: This was a retrospective study of over 10 years. From January 1998 till September 2009 a total of 991 children who underwent the procedure ranging in age from 4 mnths to 18 years and were referred from other wards of Civil Hospital Karachi, NICH, Lyari General Hospital and charitable hospitals from Lyari catchments area were analyzed. There were different reasons for referral like chronic diarrhea (for jejunal biopsy), abdominal pain, upper GI bleed, Failure to thrive, suspected acid peptic disease, CLD with or without portal hypertension, vomiting, malena, anorexia and dysphagia. Major endoscopically observed findings were gastritis, esophageal varices, GERD, duedenitis etc along with vast majority with normal or subtle findings of smaller duodenal folds and reduced sheen in cases referred for jejunal biopsy for diagnosis of Celiac Disease. It was found to be a much safer procedure than literature suggests. Conclusions: Pediatric GI endoscopy units with independently standing are limited; our endoscopy unit is one of the 3 centers operational in the country. It is an excellent diagnostic and therapeutic tool. Complications are rare in good hands. Availability of this immensely useful diagnostic as well as therapeutic tool is certainly a limiting factor in our setup but when accessible it should be utilized.