EEMR systems have become an integral part of the daily operation of many endoscopy units. Systems have evolved from simple endoscopy report generators to sophisticated endoscopy unit managers. Newer features of these systems may improve patient care and enhance endoscopy unit efficiency and productivity, but further studies are needed. The needs of the endoscopy unit, the staff, and the endoscopist should drive the selection process when choosing an EEMR. Extensive testing of the EEMR system capabilities, especially the ability to interface with existing software programs, is essential before purchasing an EEMR system.