Patients with increased pre-endoscopic anxiety take advantage of the use of conscious sedation. However, the habit of using premedication varies according to the type of endoscopic examination. Aims of this study were: to evaluate whether different endoscopic procedures may have different effects on patient anxiety; and whether anxiety affects patient tolerance. 163 consecutive outpatients undergoing endoscopy (75 gastroscopy, 51 colonoscopy and 37 bronchoscopy) were interviewed to evaluate pre-endoscopy anxiety, by using the Spielberger State-Trait Anxiety Inventory. After endoscopy, endoscopists rated patient cooperation on a 10-cm visual analogue scale. Females had state and trait anxiety levels higher than males (50.49 +/- 1.37 vs 45.07 +/- 1.20, p < 0.01; and 44.46 +/- 1.06 vs 38.48 +/- 1.01, p < 0.01). Anxiety levels were not related with the type of endoscopic procedure. A direct relationship was observed between state and trait anxiety (p < 0.001). Patient cooperation to endoscopy was inversely related with both trait (p < 0.05) and state anxiety (p < 0.01). In conclusion, gastroscopy, colonoscopy and bronchoscopy seem to induce similar pre-endoscopy anxiety levels. Therefore, the different frequency in the use of intravenous sedation between bronchial and gastrointestinal endoscopy does not seem justified.