Background: Colonoscopy is a procedure which enables a gastro-enterologist to directly image and examines the entire colon. The Aim of the work: The aim of this study was to determine the colonoscopy findings among patients referred to Al-Azhar Assiut University Hospital in the last two years, specifically in 2020 and 2021. Patients and Methods: A retrospective study included 800 patients admitted to the endoscopy unit of the Hepatology, Gastroenterology, and Infectious Diseases Department at Al-Azhar Assiut University Hospital. Results: The mean age group was 20-50, with 60.5% being male, and the most common finding was internal piles at 42.8%, followed by colonic polyps at 13.5%. There were highly statistically significant differences between normal colonoscopy and indications such as bleeding per rectum, chronic abdominal pain, and chronic constipation, as well as between normal colonoscopy and patient's age. However, there were no statistically significant differences between normal colonoscopy and patient's gender. Conclusion: Colonoscopy is an effective tool in managing various gastrointestinal pathologies. Its therapeutic role includes the ability to identify and biopsy to differentiate the nature of the pathology, as well as perform polypectomy.