Many patients with gastrointestinal (GI) symptoms go through endoscopy often unnecessarily and without indication. Observational studies have generally shown poor adherence to international guidelines of endoscopy. This study aims to identify the common indications of GI endoscopy and the subsequent findings among the population of Al Kharj Province, KSA. We conducted a cross-sectional study on 516 patients who underwent upper or lower GI endoscopy at the Endoscopy Unit of King Khaled Hospital, Al Kharj, KSA in the period from March 2017 to March 2018. GI bleeding, dyspepsia and reflux symptoms were the most commonly reported causes for referral to endoscopy (26.8%, 19.6% and 10.7% respectively). Normal endoscopic findings were reported in 33% and 37% of the patients who underwent gastroscopy with dyspepsia and reflux symptoms, respectively). Only six patients (1.8%) of those who underwent colonoscopy had an indication of colorectal screening. Almost half of the patients 45 % (45/100) with dyspepsia 53% (27/55) unnecessary gastroscopy. High rates of unnecessary upper GI endoscopy are performed for inappropriate indication such as dyspepsia and reflux symptoms. Also, colorectal screening strategy has not been adopted by the physicians. We recommend the implementation of the recent international guidelines when referring patients to endoscopy to avoid the unnecessary invasive procedures.