Although narcotics and benzodiazepines are widely used as premedications for gastrointestinal endoscopic procedures, we have found a significant number of patients in whom this combination is either inadequate for sedation or results in paradoxical agitation. Over the last 54 months, we have administered droperidol, a neuroleptic, as an adjunct to narcotics and benzodiazepines in 764 patients undergoing 1102 procedures. The most common indication for droperidol usage was active alcohol abuse or withdrawal (45%). The most frequent dose administered was 2.5 mg (41.1%) followed by 3.75 mg (25.8%). The level of sedation and cooperation was adequate in all but 22 procedures (2.0%). Complications related to droperidol use were infrequent, occurring in 17 procedures (1.5%). There was no mortality or major morbidity resulting from droperidol usage. In our endoscopic population, we find droperidol to be a safe and efficacious adjunctive agent for conscious sedation. © 1990, American Society for Gastrointestinal Endoscopy. All rights reserved.