This is one of a series of statements discussing the utilization of GI endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy (ASGE) prepared this text In preparing this guideline, the MEDLINE and PubMed databases were used to search publications through the last 15 years related to pediatric endoscopy by using the keyword ''Pediatric" and each of the following: "gastrointestinal," "endoscopy," "colonoscopy," "inflammatory bowel disease," "sedation," and "anesthesia." The search was supplemented by accessing the "related articles" feature of PubMed with articles identified in MEDLINE and PubMed as the references. Pertinent studies published in English were reviewed. Studies or reports that described fewer than 10 patients were excluded from analysis if multiple series with more than 10 patients addressing the same issue were available. The resultant quality indicators were adequate for analysis. The reported evidence and recommendations based on reviewed studies were graded on the strength of the supporting evidence (Table 1). Guidelines for appropriate utilization of endoscopy are based on a critical review of the available data and expert consensus. Further controlled clinical studies may be needed to clarify aspects of this statement, and revision may be necessary as new data appear Clinical consideration may justify a course of action at variance to these recommendations.