The volume of outpatient gastrointestinal (GI) endoscopy has grown dramatically in the past three decades, fueled by advancing technologies and evolving payment policies. This magnifies the need to ensure high-quality, safe, and cost-effective endoscopic services. In recent years, publicized breaches in standards of care for GI endoscopy have intensified the focus on patient safety. Because of these patient safety concerns and changes in regulatory policies, some ambulatory surgery center surveyors and inspectors have held GI endoscopy suites to the same standards as hospital ORs. The American Society for Gastrointestinal Endoscopy and other endorsing organizations drafted the Guidelines for Safety in the Gastrointestinal Endoscopy Unit, which published in January 2014. These safety guidelines relevant to sedation, infection control, staffing, training, technical equipment, traffic patterns, and personal protective equipment differ from other published guidelines for the outpatient surgical setting., (Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.)