INTRODUCTION: End Stage Renal Disease (ESRD) causes changes that affect every organ system including the digestive tract. These changes are manifested by a variety of symptoms and are responsible for a high degree of morbidity and mortality. The main objective of this study is to determine the most common endoscopic lesions of the upper gastrointestinal tract seen in patients with a diagnosis of ESRD. MATERIAL AND METHODS: This is a descriptive and retrospective study that included patients (age > 18 yrs.) with a known diagnosis of ESRD. The study was done at Hospital Central FAP - Hemodialysis Program from January, 2000 to February, 2007. Patients had an esophagogastroduodenoscopy (EGD) during that period of time. We conducted a chart review to evaluate medical history, demographics and EGD results. RESULTS: The study included 54 patients with a diagnosis of ESRD; mean age was 73.2 years and the male to female ratio was 1.45:1. The average time from diagnosis was 32 months and the mean blood urea nitrogen and creatinine were 94.4 and 3.9 mg/dL respectively. Symptoms were present in 37.1% of the patients and the most common cause of endoscopic evaluation was upper gastrointestinal bleed (29.6%). The most prevalent endoscopic findings included gastric erosions (35.2%), patchy antral erythema (27.8%), gastric ulcer (24.1%), and duodenal erosions (18.5%). The most common histopathologic diagnosis was superficial chronic gastritis (65.8%). Helicobacter pylori was found in 38.6% of the studied individuals. CONCLUSIONS: The most common endoscopic changes seen in patients with ESRD were gastric erosions, patchy antral erythema, gastric ulcers, and duodenal erosions.