Objective To evaluate the therapeutic value of endoscopic jejunal tube placement, endoscopic clipping, and over the scope clip (OTSC) for digestive fistula. Methods We retrospective analyzed data of 38 patients with digestive fistulas at the First Affiliated Hospital of Soochow University admitted from July 2015 to July 2017. Treatments were chosen according to the size and the site of the fistulas. Thirteen patients underwent jejunal tube placement, 20 underwent endoscopic clipping, and 5 underwent OTSC. The technical success rate, clinical cure rate and post-operative hospital stay were analyzed. Results All patients were completed the endoscopic operation successfully with no significant complications. In the jejunal tube group, 4 patients’ fistulas fully healed, lesion was smaller than before treatment in 3 patients, lesion didn"t change in 5 patients, and 1 patient died. The complete cure rate was 30.8% (4/13), and the postoperative hospital stay was 47.4±14.1 days. For the endoscopic clipping group, 16 patients’ fistulas fully healed, lesion was smaller than before treatment in 3 cases, and 1 patient died. The complete cure rate was 80.0% (16/20), and the postoperative hospital stay was 17.9±8.9 days. Patients in OTSC group were total completely cured, with 100.0% of complete cure rate. One patient with refractory esophageal fistula underwent OTSC repeatedly with endoscopic clipping, and the healing time of fistula was 102 days. The postoperative hospital stay of 4 others was 5.3±1.7 days. Conclusion Endoscopic management is safe and effective for digestive fistulas with less trauma, easy performance and short time of healing.