OBJECTIVES: Functional gastrointestinal disorders (FGIDs) are common. Diagnosis is based on the Rome criteria. It has been argued that performing endoscopies could help by providing reassurance and thus improve outcomes. This study was conducted to evaluate the impact of obtaining normal endoscopies in the outcome of children with FGIDs. METHODS: Medical records of patients diagnosed with abdominal pain related-FGIDs were reviewed. To assess the child's symptoms at follow-up, parents completed the Questionnaire on Pediatric Gastrointestinal Symptoms III (QPGS III). Primary outcome was presence of abdominal pain (AP) and secondary outcomes were AP severity. RESULTS: A total of 301 patients were diagnosed with abdominal pain-related FGIDs. Overall, 62.6% reported persistence of AP and 37.4% were asymptomatic at follow-up. Among patients with endoscopies, 61% reported AP. Among patients without endoscopies, 64% were symptomatic (P = .76). AP frequency, AP intensity, and child's disability were similar in those with and without endoscopies. CONCLUSION: The study does not suggest that a negative endoscopy improves the outcome of children with FGIDs.