Limited data are available regarding the best mechanism and timing for assessing patient satisfaction with endoscopy. To identify factors related to patient satisfaction with endoscopy and to determine if satisfaction after the procedure correlates with measurements at a later date. A prospective cohort study. Tertiary academic hospital. Patients undergoing EGD, colonoscopy, or both. Patients received preprocedure and postprocedure questionnaires on the procedure day. A third questionnaire (telephone or mail) was administered at least 1 week later. Satisfaction scores. A total of 261 patients were studied (53% men). The mean age was 55 +/- 14 years. A total of 226 patients (86.6%) were very satisfied with their endoscopy. Factors positively associated with satisfaction were as follow: doctor's personal manner (odds ratio [OR] 3.00 [95% CI, 1.80-5.03]), doctor's technical skills (OR 2.65 [95% CI, 1.55-4.51]), nurse's personal manner (OR 2.84 [95% CI, 1.74-4.63]), physical environment (OR 1.75 [95% CI, 1.16-2.64]), and more time with doctor discussing the procedure (OR 1.66 [95% CI, 1.02-2.69]). Higher levels of pain or discomfort were associated with less satisfaction (OR 0.57 [95% CI, 0.36-0.90]). A total of 141 of 261 patients (54%) were reached for follow-up (mean [SD] 39 +/- 26 days). These patients were less satisfied (rating dropped mean 0.35 points, P = .03) than those questioned sooner after the procedure and recalled experiencing more pain (rating increased mean 0.44 points, P = 0.01). Single center. This study identified several factors that impacted patient satisfaction. Most patients initially appeared very satisfied, perhaps because of residual sedation and the distinct setting of the surveys. However, patient satisfaction tended to decrease over time, possibly because of recall bias. Future studies with patient satisfaction may require assessment at a date further removed from their endoscopy.