Background: Disposable biopsy forceps have been heavily marketed as cost-effective, convenient, and safer to use than conventional forceps. Methods: In an attempt to define whether disposable or reusable biopsy forceps were cheaper to use, we prospectively evaluated the purchase price, number of uses, repair record, and cleaning costs of all reusable biopsy forceps used in the outpatient endoscopy unit of a large multispecialty clinic. Results: Over a 12-month period, 1581 biopsy sessions were undertaken. Seventeen of 119 forceps required $1890 in repairs over the study period (an average of $1.20 per biopsy session). Cleaning costs, including technician processing and steam autoclave, approximated $3.46 per use, increasing to $5.61 per use if glutaraldehyde soak was substituted for steam autoclave. Conclusions: Assuming a sixfold difference in purchase price between reusable and disposable forceps, and a per-use repair and cleaning cost of $1.20 and $3.46, respectively, reusable biopsy forceps became cost-effective after seven uses in our institution. (Gastrointest Endosc 1996;43:10-3.)