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Introduction: Hypoxemia can occur during upper gastrointestinal endoscopy with or without pharmacological sedation. Pulse oximetry saturation (SpO2) levels were assessed in patients attending for routine unsedated diagnostic upper gastrointestinal endoscopy to identify factors associated with oxygen desaturation. Methods: A total of 300 patients who underwent upper gastrointestinal endoscopy without sedation were monitored with continuous pulse oximetry. Factors related to the patient, the examination, and the monitoring data that could predict severe desaturation were evaluated. Results: Mild desaturation (SpO2 between 1-4%) was found in 143(47.7%) of the patients, while severe desaturation (SpO2≥5%) and hypoxemia occurred in 65 (21.7%) of patients, 40 (61.5%) of those had previous illnesses (p