Introduction. Endoscopic diagnostic methods play a key role in modern clinical practice. Their availability and quality are determined by the level of equipment in medical organizations and human resources. Given the growing demand for examinations within the framework of general health check-up programs for the adult population and early detection of gastrointestinal diseases, the analysis of the efficiency of endoscopic equipment use is of particular importance. Aim. To perform a comparative analysis of the availability and efficiency of endoscopic equipment use in medical organizations of the Yaroslavl Region, the Central Federal District, and the Russian Federation as a whole during 2019–2024. Materials and Methods. A retrospective analysis was conducted using official statistical reports (Form No. 30 “Information about a medical organization”) and demographic data from Rosstat. The study assessed the dynamics of the absolute number of gastroscopes and colonoscopes, the proportion of video endoscopes, equipment availability per 100,000 population and staffing levels of endoscopists. Results. In the Yaroslavl Region from 2019 to 2024, the number of gastroscopes increased from 218 to 277 (+27%), and colonoscopes from 91 to 139 (+53%). The share of video endoscopes grew to 78.7% for gastroscopes and 90.8% for colonoscopes, exceeding the average indicators for the CFD and the Russian Federation. Despite the increased provision, the workload per active gastroscope in 2024 was 258 procedures in the Yaroslavl Region, 295 in the CFD, and 379 in the Russian Federation. Similarly, the workload per active colonoscope was 130 procedures in the Yaroslavl Region and 173 in both the CFD and the Russian Federation. Discussion. The increase in the number of video endoscopes indicates a planned renewal of the equipment fleet. However, pre-pandemic utilization rates were not reached by 2024 following the decline in procedure volumes during the COVID-19 pandemic. The low utilization of endoscopic equipment points to persistent organizational and staffing barriers, as well as insufficient public awareness about screening and health check-ups. Conclusion. Despite the increased equipment provision, the problem of its underutilization persists. Improving efficiency requires a comprehensive approach: updating the equipment fleet, developing service maintenance, increasing the number of qualified personnel, and implementing modern organizational models. The enactment of Order No. 206n of the Ministry of Health of Russia dated April 14, 2025, provides for the digitalization of processes, photo and video documentation of examinations, the introduction of telemedicine consultations, and the optimization of patient routing. This comprehensive approach will enhance the quality, accessibility, and safety of endoscopic examinations within the framework of programs for the early detection of GI diseases.