Abstract: Objective: To evaluate the diagnostic role of gastrointestinal endoscopy and biopsy in children with recurrent abdominal pain (RAP). Patients and methods: Fifty children with RAP were included, their ages ranged from 3 to 15 years. All patients were subjected to detailed history, examinations, routine investigations, IgG for H. pylori, upper and lower endoscopy and biopsy. Antigliadin antibodies and indirect hemagglutination test for amebiasis. RESULTS: The endoscopic findings were abnormal in 34 cases. Erythematous mucosa, nodular mucosa then ulceration and oedema, were strongly associated with presence of histopathological findings with sensitivity 94.3%, specificity 93.3%,, positive predictive value (PPV)=97.1% and negative predictive value (NPV) = 87.5%. H. pylori infection was diagnosed in 15 patients serum IgG for H. Pylori was positive in 11 patients with sensitivity 73.3%. Endoscopic findings were positive in 13 patients with H. pylori infections with sensitivity 86.7%, while histopathological findings were positive in all patients with H. pylori infections with specificity 100%, PPV=100% and NPV =94.6%. Parasitic infestations were diagnosed in 9 patients. Four patients for each GE reflux disease and gastrodudenitis .Two patients were diagnosed for each of celiac disease, ulcerative colitis, chronic non specific colitis, duodenal ulcer and infected juvenile polyp .No etiology identified in 8 patients. Conclusions: Pediatric gastrointestinal endoscopy is a valuable and informative diagnostic procedure even in young children and can be used safely with the use of intravenous sedation.