In 2023 the third revision of the S3 guidelines on sedation in gastrointestinal endoscopy was presented. As with the two previous versions of the guidelines, the relevant and current literature was reviewed and evaluated by a group of experts from various specialist societies under the guidance of the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS). In addition to confirming some of the older recommendations, a number of recommendations were revised or newly added. A brief overview of the current version of the S3 guidelines is provided with a focus on relevant changes.