The difference between upper gastrointestinal imaging and gastroscopy is usually the different methods of examination, the different results of the examination, and the different injuries caused. 1. Different examination methods: Although both upper gastrointestinal imaging and gastroscopy require fasting. However, upper gastrointestinal imaging requires the use of an X-ray fluoroscope and contrast medium, while gastroscopy requires the use of a gastroscope with a camera. 2. Differences in results: Usually, an upper gastrointestinal imaging can only visualize the upper gastrointestinal tract. While gastroscopy can check the condition of the whole upper gastrointestinal tract, usually even slight changes in the mucosa will be detected, which is very helpful for the diagnosis of early gastric cancer. 3. Different injuries caused: Since upper gastrointestinal imaging needs X-ray fluoroscopy, it is a kind of radiation examination, so it is not applicable to some pregnant women, children and other special groups. Although there is no radiation in gastroscopy, it can cause minor injuries, which may cause obvious discomfort to the patient during the examination and may also lead to gastric mucous membrane damage and bleeding. It is recommended that patients should undergo upper gastrointestinal imaging and gastroscopy under the guidance of a medical professional.