Gastrointestinal endoscopy including colonoscopy, esophagogastroduodenoscopy, and endoscopic retrograde cholangiopancreatography (ERCP) are safe and efficacious in elderly patients. Screening colonoscopies have little efficacy in patients over 80 years. Colonoscopies performed for bleeding or iron-deficiency anemia have a higher yield in elderly patients. Colonic preparations were well tolerated and colonoscopic success rates are high in elderly patients. However, poor colonic preparation is more likely in these patients. Esophagogastroduodenoscopy is a high-yield procedure with no significant increase in adverse events in patients over 80 years with symptoms including dyspepsia and dysphagia. ERCP in the elderly carries a high degree of success with low complication rates. Elderly patients undergoing ERCP carry similar risks of bleeding and perforation and a lower risk of pancreatitis compared with younger patients. Advanced age should not be regarded as an absolute contraindication to any gastrointestinal endoscopy procedure.