Background : The decreasing reimbursement for endoscopic supplies has prompted evaluation of reuse of " single use" items. Methods : Numbered sphincterotomes (Wilson-Cook, CP-25) were used in all patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) from 1/1-12/1/96. Prior to first use and following each subsequent use, the resistance of the sphincterotome was measured with an ohms meter. After each use, the sphincterotome was flushed and then soaked in detergent, cleaned in a Steris®, and then gas sterilized. Sphincterotomes which could not be adequately cleaned or would not function properly were discarded. All difficulties with sphincterotome use were noted. The endoscopist was blinded to the number of prior uses of the sphincterotome. Follow-up for complications was performed to one month. Results: During the study period, 451 ERCPs were performed. 71 sphincterotomes were used 228 times, including 138 sphincterotomies, until they were nonfunctional. The median number of uses prior to discarding was 3 and ranged from 1-9. The single most common reason for discarding the sphincterotome was breaking of the wire to the handle which ranged from 1 to 9 uses. The sphincterotome did not cut inappropriately, as judged by the endoscopist, in any patient. Prospective follow-up disclosed few complications, none of which could be linked to reuse. Based on a cost of $100/sphincterotome, reuse over this period reduced cost to our unit by $15,700. Conclusions : "Single use" sphincterotomes can be reused multiple times without compromising use as a diagnostic or therapeutic tool. Sphincterotome reuse in busy endoscopy units is both safe and cost effective.