Introduction: In response to the COVID-19 pandemic, endoscopy centers across the nation made changes to PPE requirements, suite structures, and endoscopy indications to limit transmission risk. However, little is known about gastroenterologists’ fear levels during endoscopic procedures. This study explored gastroenterologists’ fear during endoscopy on COVID-19 suspected patients prior to and following COVID-19 vaccination. Methods: In this IRB-approved multi-center cross-sectional study, a snowball sampling approach was used to disseminate a 42-question survey, pilot-tested for reliability and validity, to gastroenterologists across the United States. Using a Likert scale from 1-10 (1 = no fear; 10 = highest possible fear level), providers were asked to rate their fear when performing their first and subsequent upper and lower endoscopic procedures on COVID-19 suspected patients before and after vaccination. Data was analyzed using ordinal logistic regression, Pearson’s chi-squared, Mann-Whitney U, and Wilcoxon rank tests with significance set at P-value < 0.05. Results: 69 responses from gastroenterologists from 30 hospitals were analyzed. Fear level reduced from first to subsequent endoscopies on COVID-19 confirmed or suspected patients prior to vaccination (mean fear level for first vs. subsequent upper endoscopies: 6.33 vs. 4.62, P < 0.0005; mean fear level for first vs. subsequent lower endoscopies: 5.21 vs. 4.1, P < 0.0005). Fear level was further reduced during endoscopies after vaccination (mean fear level for upper endoscopies before vs. after vaccine: 4.62 vs. 2.64, P < 0.0005; mean fear level for lower endoscopy before vs. after vaccine: 4.10 vs. 2.53, P < 0.0005). Using ordinal logistic regression, the highest fear level was reported by physicians living with someone who had comorbid conditions (upper endoscopy: 4.4 times higher; lower endoscopy: 6.8 times higher). This fear level persisted during subsequent endoscopies (upper: 4.7 times higher; lower: 17 times higher) before COVID-19 vaccination but not after vaccination. Conclusion: This study demonstrated that providers experienced less fear after initial upper and lower endoscopies of COVID-19 patients. There was also less fear when performing endoscopies after COVID vaccination. Physician age and geographic location did not impact fear levels during endoscopy. The infectious and psychological protection offered by the COVID-19 vaccine potentially explains the stepwise decline in fear following vaccination.