【Objective】 To evaluate the diagnostic value of endoscopic profile in adult population with heartburn symptoms. 【Methods】 A total of 326 cases patients with heartburn symptoms and underwent gastroenterology were studied in our hospital between October 2011 and October 2013. The patients were investigated through questionnaires, logical analysis by professionals. 【Results】 A total of 326 patients were complied with opt-in and exclusion criteria. The number of 121 cases (37.12%) had endoscopy positive results. The patients of 99 cases (30.37%) were diagnosed as erosive esophagitis, and 10 cases (3.07%) were diagnosed with Barrett's esophagus. The rest were peptic ulcer. Through logistic regression analysis, age (>50 years), male gender, overweight and smoking, drinking history were independent risk factors for positive endoscopy and erosive esophagitis. The old overweight male patients combined with a history of smoking and drinking had higher probability in endoscopy results and occurrence of erosive esophagitis (P <0.05). The extent and the frequency of heartburn were unrelated with endoscopic findings and the incidence of erosive esophagitis. 【Conclusion】 Patients with heartburn symptoms should be promptly endoscopy to rule out cancer, peptic ulcer. At the same time, they should be carried out 24 hours pH monitoring and esophageal acid droplets in order to ensure early diagnosis of the disease.