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Background and Aims: Endoscopic treatment is a definitive and cost-effective management strategy for early neoplasia in Barrett's oesophagus (BE). However, little is known of its impact on quality of life (QoL). This study reports outcomes of endoscopic eradication treatment (EET), focusing on QoL and costs in a Canadian tertiary referral centre., Methods: A retrospective cohort study using a prospectively maintained clinical database captured validated QoL metrics during and at the end of EET, risk factors for BE, treatment response, complications, costs, and follow-up response of all treated Barrett patients in Calgary and Southern Alberta, Canada., Results: A total of 147 BE patients were treated from 2013 to 2021. All patients showed significant improvement in almost all QoL parameters except depression. There was significant improvement in 7 of the 8 QoL metrics in those who achieved complete eradication of intestinal metaplasia (CEIM). EET was successful in achieving complete eradication of dysplasia (CED) and CEIM in 93.4% and 74.3% of patients, respectively, with a median of 3 radio frequency ablation treatments. Longer circumferential segments of BE (Cx) predicted a lower likelihood of achieving CEIM. The average total cost to achieve CED and CEIM were $10 414.58 and $9347.93CAD, respectively (compared to oesophagectomy estimated at $58 332.30 CAD)., Conclusion: This Canadian cohort reports significant post-treatment improvement in QoL parameters in patients treated to CEIM or CED over an 8-year period. EET for BE eradication is cost-effective compared to oesophagectomy. There was a low rate of complications and recurrence post-CEIM., Competing Interests: This research did not receive any specific grant from funding agencies in the public, commercial, or non-profit sectors. Authors C.A., S.C., M.G., and P.B. have received honoraria payments for lectures and presentations on Barrett’s and non-Barrett’s related talks. C.A. reports leadership role and stock options in Alimetry and Nimble Science. S.C. reports institutional Grants from Bristol-Myers Squibb Canada, Genfit, Allergan, Sequana Medical Inc., Axcella Health Inc., AstraZeneca, Merck, Ipsen, Gilead Sciences of Canada and consulting fees from Intercept Pharmaceuticals, AstraZeneca, and Novo Nordisk. P.B. reports consulting fees from AMT Vantage Endoscopy. M.G. reports travel expenses from Pentax. All other authors have no conflict of interest to report., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Canadian Association of Gastroenterology.)