Current debate surrounds the cost-effectiveness of disposable and reusable biopsy forceps. Although a complex and arduous task, performing a cost analysis may be necessary to determine which forcep type is more cost-effective. Costs associated with disposable biopsy forceps include their initial cost as well as storage and disposal costs. In addition to initial cost, costs associated with reusable biopsy forceps include reprocessing, maintenance, and repair costs. Estimating the number of times forceps are likely to be reused is also essential to evaluating the cost-effectiveness of reusable biopsy forceps. In general, once a reusable biopsy forcep performs a threshold number of procedures, it becomes more cost-effective than a disposable forcep. While reusable biopsy forceps may be more suitable and cost-effective for larger gastrointestinal endoscopy centers that perform many procedures per day, the convenience of disposable biopsy forceps may make them the more appropriate choice for centers that are smaller and perform only a few procedures each day. Due to significant decreases in the initial cost of disposable biopsy forceps, the cost-effectiveness of reusable biopsy forceps is waning. This article reviews the various issues associated with disposable versus reusable biopsy forceps and provides readers with guidelines for evaluating the appropriateness of both forcep designs in their unique practice setting.