Objective: We set out to explore the impact of gastrointestinal (GI) endoscopy training on the surgery residency program at Kamuzu Central Hospital (KCH), Lilongwe, Malawi. Methods: We reviewed the hospital and published data regarding GI endoscopy and the surgical training at KCH from 2009 to 2015. The endoscopy database was reviewed determining endoscopic procedures done during the same period. Results: Since the onset of surgical residency program at KCH in 2009, 7 residents (5 now COSECSA Fellows) have been trained as independent GI endoscopists with support from the British Society of Gastroenterology andLiverpool Malawi Wellcome trust. Between them, with supervision, 1304 upper and 28 lower GI scopes have been done; 22% therapeutic. Endoscopy capacity has improved from an average of 12 patients per week to about 30 patients per week with a well-developed oesophageal variceal banding and tumour stenting capacity. Weekly endoscopy training lists by the fellows have also been established. During the same time period, 3 papers have been published from the endoscopy data with the residents as principle investigators or co-authors. Conclusion: With dedicated support endoscopy training during surgical residency is feasible in resource poor settings and improves diagnostic capacity for better patient care ultimately benefiting trainees in gaining endoscopy diagnostic and therapeutic skills, appreciating disease spectrum and management, and exposure to research skills.