Artificial intelligence (AI) tools for endoscopy are now entering clinical practice after demonstrating substantial improvements to polyp detection on colonoscopy. As this technology continues to mature, efforts to develop and validate a new frontier of possibilities—including diagnostic classification, risk stratification, and clinical outcomes assessment—are now underway. In npj Digital Medicine, scientists from Cosmo AI/Linkverse and collaborators report an extension to the first FDA-cleared AI tool for colonoscopy that goes beyond polyp detection to enable video-based diagnostic characterization.