Background: Anxiety is common in patients undergoing endoscopy. Pre-endoscopy education may decrease the level of anxiety. Limited data on the use of educational video media in decreasing anxiety among upper endoscopy (EGD) patients are available. Aims: To compare the efficacy of a paper handout with that of video media in reducing patient anxiety in EGD Methods: A prospective randomized study from February 2010 to February 2012 was conducted. The patients were randomized into either the paper handout group (Group A) or the paper handout with video media one (Group B), and completed a validated Thai version of the State-Trait Anxiety Inventory (STAI) questionnaire assessing their state anxiety (SA) and trait anxiety at baseline and after education. Results. Ninety-one patients were recruited – 50 were in group A and 41 in group B. In Group A, SA was high in 3 participants and moderate in the other 47 at baseline, and high among 28 and moderate in the remaining 22 post education (p = 0.00). In Group B, high-level SA was observed in 4 patients and medium-level in the other 37 at baseline, and high in 13 and medium in 28 post education(p = 0.012). The baseline SAs between the two groups were not statistically different (p = 0.69). The post-education SA was lower in Group B than Group A (p = 0.02). The mean SA score + SD at baseline was 21.04 + 5.89 in Group A and 20.49 + 5.31 in Group B (p = 0.64). The mean SA score + SD after education in Group A was 22.38 + 5.82 and in Group B was 19.71 + 5.03 (p = 0.021). Conclusion: Education increased SA, and the video media reduced SA more than the paper handout.