Abstract: The clinical application of diagnostic and therapeutic gastrointestinal endoscopy under sedation and anesthesia is rapidly expanding, currently accounting for approximately 60% of all procedures. However, sedation and anesthesia during gastrointestinal endoscopy are accompanied by nonnegligible risks of safety. At present, there is a relative shortage of personnel and equipment dedicated to sedation and anesthesia management in endoscopy unit. Substantial variability exists in the implementation and management of sedation and anesthesia across different regions and medical institutions, and deficiencies remain in documentation of anesthesia records. Therefore, improving the overall standardization and safety of sedation and anesthesia during gastrointestinal endoscopy is urgently needed. To address these issues, the National Gastroenterology Quality Improvement System and the National Center of Anesthesia Quality Assurance identified 24 key clinical questions related to sedation and anesthesia management in gastrointestinal endoscopy through online interviews, questionnaire surveys, and expert voting. Based on systematic evidence retrieval, critical appraisal of evidence quality, and a structured recommendation formulation process, a total of 41 recommendations were ultimately developed. This guideline aims to provide standardized, evidence-based guidance for the implementation and management of sedation and anesthesia in gastrointestinal endoscopic procedures, so as to improve the safety and quality of the overall healthcare.