Pediatric gastrointestinal endoscopy must be performed by an experienced operator within an appropriate environment for the safety of patients. Studies evaluating the quality and safety of pediatric endoscopy are scarce and none has attempted to evaluate the whole process. Quality indicators in adult digestive endoscopy exist, but might not be translated to children. Our aim was to identify quality indicators in pediatric digestive endoscopy and to implement a quality and security program in a university hospital center.