Problem: Esophagogastroduodenoscopy (EGD) is a common procedure used to diagnose and treat various gastrointestinal disorders. Certain patient populations, such as those with obesity where BMI > 30 kg/m2, have a higher risk of hypoxia while under anesthesia for EGDs. Evidence shows that using high-flow nasal cannula (HFNC) during similar procedures decreases the risk of hypoxia (defined as SpO2 < 90%) as compared to using other oxygen delivery devices. In the Endoscopy Unit at a large academic tertiary care hospital, only 12% of obese patients received HFNC during EGDs between October 2023 and February 2024. Purpose: The purpose of this quality improvement initiative was to promote the utility of HFNC in reducing the risk of hypoxia in obese patients undergoing EGDs. Methods: Using fliers, educational emails, and presentations, the project team informed the Anesthesia Department of the evidence promoting this practice change. Any anesthesia provider (including anesthesiologists, certified registered nurse anesthetists, and anesthesiologist assistants) caring for a patient scheduled for an EGD with a BMI > 30 kg/m2 was encouraged to utilize HFNC. Weekly retrospective chart audits of the electronic medical record were performed to record HFNC use and incidence of hypoxia during EGDs of eligible patients. Results: The quality improvement initiative was implemented over a 15-week period in the Fall of 2024 and impacted 332 patients and approximately 140 anesthesia providers. During the project implementation, 21.5% of patients received HFNC during EGDs and 23 total hypoxic events occurred. Only one hypoxic event occurred when HFNC was used. Conclusions: Data from this project is consistent with broader research and demonstrates the benefit of using HFNC to prevent hypoxia in obese patients during EGDs. Keywords: high-flow nasal cannula, obesity, esophagogastroduodenoscopy, hypoxia