Esophagogastroduodenoscopy (EGD) is considered an essential diagnostic and therapeutic procedure in the pediatric population. Although generally safe, EGD has the potential for airway complications. We routinely use general anesthesia to carry out EGD in patients younger than 10 years. In the past, these patients received oxygen either through a nasal cannula or were intubated; both modalities have drawbacks and may be associated with complications. Here we report our experience using a modified endoscopy mask, devised primarily for bronchoscopy, for upper endoscopy in children under general anesthesia. RESULTS: Two hundred forty children (122 boys and 118 girls) participated in the study. Age range was 7 to 135 months (mean 60.7 +/- 34.4 months). All patients maintained a stable hemodynamic status throughout the procedure. Ventilation was satisfactory in 230 patients. It was difficult in 9 patients, and external airway maneuvers had to be applied. Ventilation was impossible in only 1 patient (10 months old), and endotracheal intubation was performed. There were no procedure-related complications. CONCLUSION: The modified endoscopy mask is efficient and safe and should be recommended for routine use for upper endoscopy under general anesthesia in children older than 6 months.