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Background and Objective: Colonoscopy is the best method for management of patients with Hematochezia or lower gastrointestinal bleeding (LGIB). This study was conducted to assess the endoscopic and histopathologic findings in patients with hematochezia. Methods: This descriptive –analytical study was done on 117 (50 males, 67 females) patients whom referred to 5th Azar hospital in Gorgan, northern Iran during 2010. Demographic characteristics, medical history and colonoscopic and histopathologic findings were recorded for each patient. Results: Hemorrhoid was the most common finding in colonoscopic examination. Inflammatory bowel disease (IBD) and cancer were the most common feature in the under and higher than 43 age old patients, respectively (P<0.05). Ulcerative colitis (22.2%) was the most common finding in histopathological examination. Rectosigmoid was the most common anatomical location of involvement in IBD cases. Cancer and IBD were occurred in the left colon. Conclusion: Flexible sigmoidoscopy can be a selected procedure for evaluation of hematochezia in the <43 age old patients but in >43 age old subjects sigmoidoscopy or colonoscopy should be made based on patients' status.