Background and Study Aim <p>Over three million hospital admissions are made annually in the United States for gastrointestinal diseases, one-third of which result in inpatient endoscopic procedures. Delays in procedures have medical and financial implications, including prolonging hospital stays, decreasing quality measures, and reducing patient satisfaction. We aim to identify factors affecting inpatient procedures’ timely performance.</p> Patients and Method <p>We conducted a prospective 15-week analysis of scheduled outpatient and inpatient procedures. We recorded the number of add-on procedures, including those completed in designated or alternate rooms, and the number of canceled and delayed procedures.</p> Results <p>Of 1,467 total procedures, 473 were add-on inpatient procedures. Interventional procedures were significantly more likely to be delayed than general procedures (41.3 vs. 25.3%, <i>P</i> = 0.03). Delays were most frequent on Mondays (34%) and Tuesdays (30%). Mondays also had the highest mean number of add-on procedures, followed by Tuesdays (<i>P</i> &lt; 0.01). Patients were most often returned without a procedure on Fridays (16.7%), followed by Mondays (13.3%) (<i>P</i> &lt; 0.01).</p> <p>Independent predictors of delayed procedures included the number of scheduled outpatient procedures (Odds Ratio [OR]: 6.76, 95% Confidence Interval [CI]: 2.24–20.35, <i>P</i>: &lt; 0.01), number of added inpatient procedures (OR: 11.78, 95% CI: 4.82–28.82, <i>P</i>: &lt; 0.01), and number of interventional cases (OR: 16.90, 95% CI: 11.76–24.26, <i>P</i>: &lt; 0.01). Risk factors for patients being returned without a procedure included the number of add-ons (OR: 6.27, 95% CI: 2.16–18.17, <i>P</i> &lt; 0.01) and scheduling on Fridays (OR: 9.74, 95% CI: 1.17–80.90, <i>P</i> = 0.03).</p> Conclusion <p>High outpatient procedure volume on certain days impedes timely inpatient endoscopy. Adjusting schedules on high-burden days may reduce delays, improve access, and enhance outcomes.</p>