Endoscopic outcomes analysis has become an increasingly important topic as attempts to measure outcomes, define costs, and compare the relative costs and benefits of different diagnostic and therapeutic procedures have become a major focus of the health care community. This article (1) defines the potential benefits and medical effects of endoscopy; (2) reviews the economic and social pressures fostering the increased focus on health care outcomes research; (3) explores the basic principles, approaches, and paradigms used in health care outcomes analysis; and (4) illustrates how health care outcomes research can help to guide therapeutic approaches, such as endoscopy, in patients with abdominal pain or inflammatory bowel disease.