Dyspepsia is one of the commonest presentations of gastrointestinal disorders in our region with a Global prevalence of between 7-45% and a regional prevalence of 65%. Most studies on dyspepsia have differences in findings and proposed standard of care. The current practices in our setting are centered on blood and stool Helicobacter pylori antigen and antibody investigations and initial treatment with PPIs and antibiotics before referral for endoscopy and biopsy. This study is to describe the commonest presenting complaints, endoscopy and histopathology findings in patients with dyspepsia in our setting. A descriptive cross-sectional study in which 115 dyspeptic patients who presented to St Francis hospital, Nsambya underwent endoscopy and biopsy. Consecutive sampling was used. Dyspepsia prevalence was more among the male at 53.9% than the female at 46.1%. The mean age of participation in this study was 53 years. The commonest presenting complaint was epigastric pain which was noted in 63.6% of the participants followed by hematemesis in 14.3% and vomiting feeds in 6.4%. Most of the patients at presentation had only one clinical symptom (80.9%) while those with more than one presenting symptom were (19.1%). There was no relationship between the age and sex and the presenting complaints among patients with p=0.290 and p=0.680 respectively. The commonest findings at endoscopy were gastritis-73 participants, followed by PUD- 23, Duodenitis- 22, GERD-17, Oesophagitis-15, Tumor-11, Hernia-9, Polyps-4. No normal findings were noted at endoscopy. At histology, there was no reported normal mucosa, the most common finding was gastritis in 62.6% of the patients. 10.4% participants had gastric malignancy and 1.7% had intestinal metaplasia. Of 3 patients diagnosed with Peptic ulcer disease at endoscopy, 2 had intestinal metaplasia and one had gastrointestinal stromal tumor at histology. The concordance rate between endoscopy and histology was 76.9%