Background: Study objectives included assessing and monitoring the safety of endoscopic procedures using microbiologic cultures and electronic medical records, evaluating for 30-day microbiologic results after endoscopic procedures. It is imperative that disinfection should eliminate the transmission of endoscope procedure-related infections. Monitoring is essential to ensure safety of endoscopes using routine microbiologic cultures and clinical evaluation after procedures. Methods: A risk adjusted plan was made for the frequency of microbiologic cultures of endoscopes (1-3 times per year). An electronic medical record system was reviewed for all GI procedures in the medical center for the 1st quarter of 2017. Positive cultures were identified as bacteria present within 30 days from/including the case date in the sputum, blood, or broncho-alveolar lavage (BAL) of the patient. Negative cultures included any criteria outside of the positive culture definition. Results: 1,044 endoscopic procedures were performed between January 1st, 2017 to March 31st, 2017. There were 18 endoscope microbiologic cultures performed within the same time frame and 19 positive cultures identified from the electronic medical records. Review of the records was likely unrelated to the endoscope itself and due to endogenous infection. Microbiologic cultures were normal and routine. Conclusions: Clinical and microbiologic monitoring of endoscopes are essential for the safety of patients and should be performed routinely in real time to serve as an early detection system. Infectious outbreaks related to endoscopic procedure remain rare but devastating events.