The endoscopic electronic medical record (EEMR) has the potential to increase greatly the efficiency of both the endoscopist and the entire endoscopy unit. Potential efficiencies depend on the specific situation of the endoscopist and the type of endoscopy unit. This article describes a number of features available in current EEMRs as well as some emerging features that are important for future databases. Additionally, some aspects of equipment and staff needed to implement a successful EEMR are discussed.