The aims of the present study were to determine practice patterns of Canadian gastroenterologists for screening patients with Barrett's esophagus and to compare current practice patterns with published guidelines. A secondary goal was to evaluate whether gastroenterologists recommend a "once in a lifetime" endoscopy for patients with chronic gastroesophageal reflux disease. A structured questionnaire regarding screening for Barrett's esophagus was sent to members of the Canadian Association of Gastroenterology. The overall response rate was 51% (203 of 396). Of the 203 respondents, 165 (81%) performed endoscopies in adults and form the basis of this report. The majority of Canadian gastroenterologists followed published guidelines, with 62% screening patients without dysplasia every two years. Patients with low grade dysplasia were screened more frequently, with 54% of respondents performing endoscopy every six months, and 35% on a yearly basis. Biopsy protocols showed the greatest variation, with 46% of gastroenterologists taking four-quadrant biopsies at 2 cm intervals along the columnar-lined (Barrett's) esophagus. Seventy-six per cent of gastroenterologists agreed that all patients with chronic gastroesophageal reflux should have a "once in a lifetime" endoscopy to screen for Barrett's esophagus. The majority of Canadian gastroenterologists follow current guidelines for the management of Barrett's esophagus and support the concept of "once in a lifetime" endoscopy.