Open access endoscopy (OAE) is widely used in many hospitals. The aim of this study was to compare the upper gastrointestinal endoscopies referred to as "OGDs" performed under the OAE service and those referred from hospital outpatient clinics (HR) during the initial year in which an OAE service was provided in a district general hospital. A retrospective review of medical records from all patients undergoing OGD during the first year of OAE to identify the waiting time for OGD, the extent of pre-treatment at the time of OGD, the endoscopic findings and the number of endoscopies in which oesophageal or gastric neoplasia was detected. Follow-up endoscopies (n = 41) were excluded. Of 739 OGDs included, 384 (177 male; mean age 48.0 yrs.) were performed under the OAE service, 346 (149 male; mean age 50.7 yrs.) were referred from outpatient clinics and 9 could not be accurately classified. The waiting time was significantly lower in the OAE group compared to the HR group (24.5 v. 29.8 days, p<0.001). Pre-treatment at the time of OGD was significantly more frequent in the OAE group compared to the HR group (295 v. 186, p<0.001). Frequencies of the main endoscopic diagnoses did not differ significantly between the two groups. The OAE service provided faster access to OGD than the HR group and the endoscopic findings were similar in the two groups.