Background:Oesophageal stents (OS) are frequently used for malignant and benign oesophageal conditions, especially for palliative care in patients with obstructive lesions. While OS provide symptomatic relief, complications such as stent migration, re-obstruction, and re-stenting can occur. Stent fixation techniques, over-the-scope clips, aim to prevent these issues. Understanding the impact of stent fixation on complication rates could help optimize stent management. Aims:To compare the rate of clinically significant OS complications, defined as unplanned endoscopic intervention, between groups, including those with stent fixation.Methods:single-centre retrospective cohort study follow-up of 90 days. Inclusion criteria: adults (≥18) undergoing OS insertion for benign or malignant indications between June 2021 and December 2025. Demographic, re-scope, re-stent, re-admission, and mortality data collected. Results:102 patients (31.4% female, mean age 71) underwent OS insertion. 88.2% had malignant lesions, and 81.4% were inserted by gastroenterologists. Median length of stay was 4 days. 30-day re-admission occurred in 41 patients (40.2%), and 90-day mortality was 54.9%. Stent migration occurred in 10 patients (31.3%). 36 patients (35%) required unplanned repeat endoscopy, with re-stenting needed in 1/10 (10%) cases where the stent was fixed with a through-the-scope (TTS) clip, compared with 15/26 (58%) cases without fixation (odds ratio 0.08, 95% CI 0.01–0.72, p = 0.01). Conclusion:Stent fixation significantly reduced re-stenting, indicating its potential to lower clinically important complications. While the availability of over-the-scope clip (OTSC) fixation devices has reduced technical barriers, cost and access remain concerns. Further studies are needed to assess cost-effectiveness, patient selection, and optimal fixation strategies. Ramai, Daryl MD, MSc1, et al.Success Rates of Fixation Techniques on Esophageal Stent Migration: A Systematic Review and Meta-Analysis. The American Journal of Gastroenterology 118(10S):p S997-S998, October 2023.