Methods: Retrospective cohort study including consecutive patients with early ampullary tumour, with or without familial adenomatous polyposis (FAP) who underwent EP between December 2012 and January 2022. Outcome parameters included complications (as defined by ASGE guidelines), rate of recurrence and success of endoscopic resection. Results: Thirty-seven patients (13 with FAP) underwent 46 EP procedures, mean age at intervention was 66.1±11.25 years, 27% presented cholestasis. Procedural characteristics are outlined in Table 1. Complications occurred in 13 procedures (28.2%); in some, more than one was registered. The most common complication was bleeding (19.6%) th e majority of moderate severity, followed by cholangitis (8.7%) and perforation (6.5%). Recurrence occurred in 21.2% (7/33) of patients over a median follow-up of 24 months (range 1–76 months), 4 patients excluded due to presence of duodenal submucosal invasion in the resected specimen. There was not a significant association between recurrence and FAP (X2(1)=0.59, p=.594) or piecemeal resection (X2(1)=2.95, p=.096). Endoscopic resection was successful in 91% (30/33) of patients, of which 26 patients (86.7%) required only the index procedure to achieve lesion clearance, while the remaining required two to three procedures.Conclusions:Endoscopic ampullectomy is an effective and minimally invasive therapeutic modality for non-invasive ampullary lesions, in addition to being a valuable diagnostic tool. Nevertheless, careful patient selection and a commitment to endoscopic follow-up are of primary importance to achieve an optimal therapeutic outcome.