Purpose Guidelines for perioperative management of antithrombotic medications during endoscopy are substantiated by limited evidence. Balancing thrombotic risk with haemorrhagic risk is a difficult decision. The risk of haemorrhage from polypectomy is approximately 0.07-1.7%, which is expected to be greater in patients on antithrombotic therapy. This Australian study investigated the risk of bleeding associated with antithrombotic agents in patients requiring endoscopic biopsy and/or polypectomy. Methodology A single-institution, retrospective cohort analysis examined patients who underwent endoscopic biopsy and/or polypectomy between 2018 and 2022 at Cabrini Hospital in Victoria. Data was derived from patient records. Of 1486 patients included, 89 patients were on pre-operative anticoagulant or antiplatelet agents. Patients on aspirin monotherapy were excluded. Primary outcomes included post-operative haemorrhage requiring unplanned admission to hospital, blood transfusion or return to theatre. Thrombotic events within the same post-operative period were also recorded. Results Of these 89 patients, 75 were on a single anticoagulant medication, 12 were on a single antiplatelet medication and 2 were on both apixaban and clopidogrel. Overall, 1 patient suffered post-operative haemorrhage requiring a return to theatre for endoscopic clipping. 2 patients had their endoscopies repeated a second time for definitive polypectomy following cessation of antithrombotic medication. There were no thrombotic events reported. Conclusion This study was able to demonstrate that remaining on antithrombotic medication for endoscopy with biopsy and/or polypectomy has comparable haemorrhagic complication rates to those reported in the literature.