OBJECTIVE: This study is a retrospective evaluation of a new outpatient flexible cystoscopy service in a tertiary care hospital in Dublin, Ireland. DESIGN: This is a retrospective observational study. SETTING: This study has been held at the Department of Gynaecology, Rotunda Hospital, Dublin. POPULATION: This included all women who underwent outpatient flexible cystoscopy in Rotunda Hospital between May 2023 to October 2024. MATERIALS AND METHODS: Retrospective data collection included patient demographics, indications for referrals, cystoscopic findings, post-procedural complications, and cost-benefit analysis. RESULTS: A total of 77 women underwent flexible cystoscopy. The mean age was 52.5 years ranging from 20 to 85 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 months. CONCLUSION: 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.