Background: The decreasing reimbursement for endoscopic supplies has prompted evaluation of reuse of 'single use' items. Methods: Over a 12.5- month period, numbered sphincterotomes were used for sphincterotomy or as a diagnostic catheter in all patients undergoing endoscopic retrograde cholangiopancreatography. Before first use and after each subsequent use, the resistance of the sphincterotome was measured with an ohmmeter. After each use, the sphincterotome was thoroughly cleaned and gas sterilized. Sphincterotomes that could not be adequately cleaned or would not function properly were discarded. The endoscopist was blinded to the number of prior uses of the sphincterotome. Results: During the study period, 80 sphincterotomes were used 290 times, including use in 162 sphincterotomies. The median number of uses before discarding was 3 and ranged from 0 to 10. The single most common reason for discarding the sphincterotome was breakage of the wire to the handle which occurred after 1 to 9 uses. The sphincterotome did not cut inappropriately in any patient, and no complications were linked to reuse. Equipment costs to our unit were reduced $21,000 by reuse. Conclusions: 'Single use' sphincterotomes can be safely reused multiple times without compromising their use as a diagnostic or therapeutic device.