During 11 years of an open-access endoscopy service for general practitioners the proportion of positive diagnoses has remained relatively constant. There has been a progressive fall in the incidence of duodenal ulcers but an increase in oesophagitis which is now the single most commonly detected abnormality. The number of barium meal requests has fallen by approximately 50%. A study of cimetidine prescribing suggests that use of the open-access service results in fewer inappropriate prescriptions.