Background: Gastroparesis can have varied clinical presentation. There are no well defined clinical parameters for predicting gastroparesis in patients presentingwith different gastrointestinal symptoms. Aims: To assess clinical predictors of gastroparesis in a large cohort of patients undergoing gastric emptying test Methods: A retrospective chart review of patients referred to our tertiary care center with presumed diagnosis of gastroparesis and various combinations of abdominal symptoms (nausea, vomiting, abdominal pain, bloating, post parandial fullness and early satiety) were included. All patients underwent a standardized 4-hrs scintigraphic gastric emptying test (GET) consisting of low-fat (2%) isotope labeled egg beaters meal of 250 kcal at our center. Patient demographics, medical/surgical history, drug use (affecting gastric/GI motility), proton pump inhibitor (PPI) use, endoscopic findings and results of hydrogen breath test were noted. Patients with previous history of gastric or small bowel resection, IBD, significant co-morbidities (end stage liver, kidney disease) were excluded. A univariate analysis was performed using Fisher's exact to evaluate predictors of gastroparesis, variables with a significance (p<0.05) were further evaluated using a multivariate logistic regressions model to identify independent predictors for gastroparesis. Results: 217 patients (mean age 46 yrs, 77% females, 83% Caucasians, average BMI 29 kg/m2, 18% smoker and 32% alcohol use history) were included. The frequency of gastrointestinal symptoms were: nausea 70%, abdominal pain 54%, vomiting 45%, bloating 34%, early satiety 14%, constipation 35%, and associated heart burn or acid reflux 40% and weight loss 30%. Diabetes mellitus (DM type 1 and 2) were present in 25% patients, 30 % had cholecystectomy history and 37% carried a diagnosis of depression. A total of 42% (92) patients had DGE (mild = 53%, moderate = 31%, severe = 16%) and of these 33% had diabetic gastroparesis and rest had idiopathic gastroparesis. In univariate analysis presence of nausea, DM, chronic use of PPIs were significant predictors for delayed gastric emptying (DGE), however, in multivariate analysis there was no independent clinical variable that predicted DGE, Table 1. Similarly, in patients with DM no clinical predictors for presence of DGE were identified. The number of patients with moderate and severe delay in gastric emptying was comparable between diabetic gastroparesis and idiopathic gastroparesis patients: moderate 30% vs. 31% and severe 16% vs. 18 %, respectively. Conclusion: In a large cohort of patients presenting with varied gastrointestinal symptoms, there was no independent clinical factor that predicted gastroparesis. Future RCTs are needed to confirm these findings. Clinical parameters in patients with delayed and normal gastric emptying