BACKGROUND: Due to advancements in cardiovascular intervention technologies, transesophageal echocardiography (TEE) is increasingly used. In Japan, nurse practitioners are being integrated into specialized procedures, including TEE, under physician supervision to address physician shortages and improve patient safety. METHODS: Consecutive patients undergoing TEE at our outpatient clinic from July 2022 to June 2023 were included, with baseline characteristics, procedural details, and outcomes retrospectively collected. RESULTS: A total of 186 patients were included in the study. A significant decrease in blood pressure was observed in 124 patients (68.5%), with 19 patients requiring treatment through infusion loading. Desaturation (SpO2 <
90%) was observed in 105 patients (57.7%). No significant differences in hypotension or hypoxia incidence were found between elderly and younger patients or among TEE indications. CONCLUSIONS: TEE procedures were safely performed under the assistance of nurse practitioners, demonstrating effective management of the procedural risks associated with this diagnostic technique.