The present paper discusses where endoscopic diagnosis and treatment will be in 10 years. The demand for gastroenterologist services is growing, driven partly by the aging population and the popularity of screening colonoscopy. Hopefully, along with better genetic and fecal markers, it will allow colonoscopy to be used much more efficiently in patients who really need it. Innovations in reduction of pressure on patients by decreasing the diameter of the electron endoscope, particularly the transnasal endoscope, are continued, in parallel with the development and research of capsule endoscopy as a tentative measure. There will be issues regarding will perform the screening test, and how the medical expenses should be established. In contrast, highly precise imaging techniques are progressing. The most important theme of endoscopic medicine is the further prevalence of and development of therapeutic endoscopy in such situation as gastroesophageal reflux disease, obesity, hemostasis, luminal stenosis, endoscopic submucosal dissection for early gastrointestinal cancer, stenting, endoscopic shincterotomy and natural orifice translumenal endoscopic surgery for pancreatic biliary or other diseases. In addition, the field of gastroenterology and gastrointestinal endoscopy will need to evolve into one of the digestive health sciences, a new multidisciplinary specialty. It will be required to have a department of digestive diseases integrating all specialists in this field.