Various methods, indications and technical devices for endoscopic resections are available. Degrees of artificial changes that may hamper the histopathological diagnosis vary from method to method and from gastroenterologist to gastroenterologist. Indications for endoscopic resections are nowadays seen wider as compared to ten years ago. This leads to a situation that more institutions and gastroenterologists offer these new methods for their patients. Indirectly, pathology is involved also since most of these specimens will not be sent to one dedicated experienced pathologist anymore but to many local pathologists that may not see enough specimens to properly train their skills in a routine setting. The same is true for the gastroenterologists outside the larger centers that are already applying these methods for a longer time. The quality of the specimen is very central for a correct diagnosis and it already starts in the endoscopy suite that the quality can be hampered. The following article provides hints on how to keep the quality of such a specimen as high as possible for gastroenterologists and pathologists and gives some diagnostic advice for pathologists as well.