Objective <p>This study is a retrospective evaluation of a new outpatient flexible cystoscopy service in a tertiary care hospital in Dublin, Ireland.</p> Design <p>This is a retrospective observational study.</p> Setting <p>This study has been held at the Department of Gynaecology, Rotunda Hospital, Dublin.</p> Population <p>This included all women who underwent outpatient flexible cystoscopy in Rotunda Hospital between May 2023 to October 2024.</p> Materials and methods <p>Retrospective data collection included patient demographics, indications for referrals, cystoscopic findings, post-procedural complications, and cost–benefit analysis.</p> Results <p>A total of 77 women underwent flexible cystoscopy. The mean age was 52.5&#xa0;years ranging from 20 to 85&#xa0;years. Flexible cystoscopy was successfully completed in all patients, and there were no post procedure complications. The most common indications were as follows: recurrent urinary tract infections (36%) and bladder pain syndrome (36%), followed by overactive bladder symptoms (14%). Fifty-five percent of patients had no abnormal findings. The most common abnormality found was trabeculations (39%), followed by glomerulations (9%). A cost–benefit analysis showed an approximate saving of € 1211 per patient leading to a saving of over € 93,000 over a period of 18&#xa0;months.</p> Conclusion <p>Outpatient cystoscopy is a low-risk, feasible, well tolerated, and safe diagnostic procedure, with no post-procedure complications observed in this study. It avoids the risks of general anaesthesia and is associated with lower procedural costs.</p>