Gastrointestinal endoscopy has seen great changes over recent years, and the future seems bright. Looking forward, some advances in technology can be predicted, but the current financial climate may limit their widespread adoption. Increasing subspecialisation with continuing service development and quality assurance are likely to form the basis of the major changes over the next 5 years. Increasing juxtaposition between laparoscopic and endoscopic procedures presents the most exciting opportunities over the 10-year timeframe. This article extrapolates current trends to try to predict the different possibilities for endoscopy over the next decade.