New high resolution upper endoscopy technology enables the endoscopist to directly visualize the villi of the duodenum.The Aim of this study was to determine whether all cases of celiac disease are able to be picked up endoscopically prior to histology Methods All patients presenting for a routine upper endoscopy in a single endoscopy centre over 4 weeks( n=225) were assessed by a single operator for the macroscopic evidence of celiac disease using the new high resolution Olympus upper endoscope.Duodenal histology was routinely performed on all these patients to asess for the presence of celiac disease Results All 4 patients with celiac disease were detected endoscopically by the presence of partial or total loss of villi macroscopically.5 patients had minor duodenal nodularity without villous loss ,none had histological celiac disease. None of the 216 macroscopically normal patients had celiac disease by standard histological criteria. Conclusion Using the high resolution endoscope all celiac patients can be confidently diagnosed endoscopically reducing the need for small bowel biopsies.