Endoscopy volumes continue to grow despite steady cut-backs in reimbursement. Significant physician and paramedical personnel time is needed to meet this growth providing less time for endoscopic research and development. AIM: To create an environment that facilitates endoscopic research and development. METHODS: A physician and paramedical personnel core group was assembled to include a director, lead gastrointestinal assistant, study coordinator, and research fellow. Dedicated space and equipment were provided. Contacts were established with industry to seek mutual areas of equipment, accessories, and technique development with an emphasis on confidentiality. A system of record keeping using the latest information technologies was established with a monthly and yearly reporting schedule for all activities. The working unit created was entitled the Developmental Endoscopy Unit (DEU). RESULTS: The DEU began operation on 8/1/98. The activities which evolved include: clinical research, prototype endoscope and accessory testing, animal research of new endoscopic techniques, the performance of complex clinical cases using cutting edge technology, and the invention of new equipment. The DEU physician endoscopist staff has grown from one to six. Planned personnel growth includes the addition of a gastrointestinal assistant and research coordinator. A total of 14 new research protocols were initiated the first year by the original core group. Projects include the study of high resolution and high magnification endoscopy, endoscopic anti-reflux methods, and tissue resection techniques. CONCLUSIONS: 1. Given the demanding pace of clinical endoscopy, it is possible to successfully assemble a working unit dedicated to promote the advancement of endoscopic care. 2. The DEU core group was able to efficiently establish a large number of both clinical and animal research projects. 3. The DEU structure enhanced communication and a developmental liaison with industry.