Aim: The aim of this retrospective study is to analyze the colonoscopic findings and to identify the yield of the major indications for colonoscopy and the pattern of colorectal diseases in our community.Patients and Methods: A retrospective study conducted during the period from May 2004 to December 2007 to analyze the colonoscopic findings of patients presented with lower gastrointestinal manifestations to the Gastrointestinal Endoscopy Unit of Kasr El-Aini Hospital. It included 3698 cases, 2129 were males (57.6%) and 1569 females (42.4%). Their ages ranged from 1 to 90 years with a mean age of 40.9. Of whom 90% aged above 18 years. Complete examination up to the cecum or terminal ileum was possible in 2331cases (63.5%).Results: Bleeding per rectum was the commonest presentation representing 47.6%, followed by constipation (14.6%), abdominal pain (12.6%) and diarrhea (9.5%). Pathological findings were identified in 2054 patients (55.5%). Polyps, colitis, ulcers, piles and mass were the commonest findings followed by angiodysplasia, diverticulosis and stricture. The highest diagnostic yield was found in patients presented by bleeding per rectum (65%) followed by anaemia (55%), follow up of malignancy (51%), constipation and screening for malignancy (45%) for each, abdominal pain (43%) and diarrhea (42%). Conclusion: Colonic diseases are not uncommon in our part of the world. Colonoscopy is a rewarding procedure in those patients referred with lower gastrointestinal manifestations.