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Sterilization of endoscopic instruments is an important but often ignored topic. The purpose of this article is to review the current literature on the sterilization of endoscopic instruments and elaborate on the appropriate sterilization practices.Autoclaving is an economic and excellent method of sterilizing the instruments that are not heat sensitive. Heat sensitive instruments may get damaged with hot sterilization methods. Several new endoscopic instruments such as flexible ureteroscopes, chip on tip endoscopes, are added in urologists armamentarium. Many of these instruments are heat sensitive and hence alternative efficacious methods of sterilization are necessary. Although ethylene oxide and hydrogen peroxide are excellent methods of sterilization, they have some drawbacks. Gamma irradiation is mainly for disposable items. Various chemical agents are widely used even though they achieve high-level disinfection rather than sterilization. This article reviews various methods of endoscopic instrument sterilization with their advantages and drawbacks.If appropriate sterilization methods are adopted, then it not only will protect patients from procedure-related infections but prevent hypersensitive allergic reactions. It will also protect instruments from damage and increase its longevity.