Upper gastrointestinal fibreoptic endoscopy, performed on 1,084 Ethiopians, revealed: 48 (4%) oesophageal varices, 16 (1%) oesophageal carcinoma, 394 (36%) chronic atrophic gastritis, 36 (3%) gastric carcinoma and 154 (14%) duodenal ulcer. Oesophagitis, gastric ulcer and stomach ulcer are rare. The high prevalence of oesophageal varices and the association of chronic atrophic gastritis with gastric carcinoma are noted. There is a poor correlation between barium meal and endoscopic findings mainly because of inadequate radiological services in the country. All 16 patients who had endoscopy within 48 hours of haematemesis and/or melena had the source of bleeding identified. In a country like Ethiopia where upper gastrointestinal symptoms are very common and radiological services inadequate, expert endoscopic studies can be of great diagnostic value.