Problem: The loss of biological specimens jeopardizes patient safety by causing diagnostic delays or errors. Over three years, an academic hospital’s Endoscopy Suite lost three surgical pathology specimens—classified as “Never Events” by the National Quality Forum— highlighting vulnerabilities in the specimen handling process. Manual documentation and electronic label printing create tracking inconsistencies and an unclear chain of custody. Evidence supports electronic tracking to mitigate these risks and improve patient outcomes. Purpose: This quality improvement project aimed to eliminate surgical pathology specimen loss in an academic hospital’s Endoscopy Suite by implementing barcode scanning for specimen tracking. This approach reduces pre-analytical errors and enhances patient safety for adults undergoing endoscopic procedures. Methods: The project required structural and process changes, including installing barcode tracking hardware and software and transitioning from paper documentation. The Project Lead and Unit Champions provided on-site training and support, while biweekly multidisciplinary meetings addressed staff concerns. Staff adherence to scanning protocols was monitored via electronic health record reports. Results: During the 13- week implementation, 3,067 specimens were processed using barcode tracking, with a median staff adherence rate exceeding 94% at each checkpoint. After staff re-education, adherence improved, particularly at the ‘OR Room’ checkpoint. Most importantly, no specimens were lost, demonstrating significant improvements in specimen management and patient safety. Conclusion: Barcode scanning significantly improved adherence and eliminated specimen loss, reinforcing its effectiveness in specimen management. Continued training and targeted interventions could further enhance compliance, ensuring long-term reliability and patient safety. Keywords: specimen loss, barcode tracking, quality improvement, pre-analytical errors