Rwandan Endoscopy Week (REW) provides high-volume gastrointestinal (GI) diagnostics and treatment across multiple hospitals each year, yet patient follow-up after REW remains inconsistent. This quality-improvement project assessed follow-up outcomes across four of nine REW 7.5 sites, reviewing 884 total cases and identifying 398 patients requiring follow-up—most commonly for H. pylori eradication. Chart review and phone outreach revealed substantial barriers: inconsistent survey data collection, variable use of electronic medical records, and limited patient awareness or motivation to pursue follow-up. Financial barriers, symptom improvement, and communication gaps further contributed to low adherence. Organizational limitations affected the ability to track outcomes effectively. Recommendations include standardizing data collection, improving communication regarding follow-up instructions, and enhancing access pathways for care continuity. These findings underscore the need for integrated organizational and patient-centered strategies to strengthen longitudinal GI care in Rwanda.