Abstract: OBJECTIVE This study aims to evaluate the cleaning effectiveness and operational efficiency of an automated bedside washer compared to traditional manual operations in the reprocessing of flexible endoscopes. METHODS A total of 160 endoscopes were randomly divided into an experimental group (n=80) and a control group (n=80). The experimental group underwent endoscope pre-cleaning with an automated bedside washer, while the control group adopted traditional manual operations. The cleaning efficiency of the machine was assessed by detecting the results of microbial cultures, adenosine triphosphate (ATP) concentrations and the time taken for bedside pre-cleaning and leak detection. RESULTS The ATP concentrations in the two groups were 584.50 (212.00, 2 901.50) RLU and 1 277.00 (259.50, 3 290.00) RLU, respectively (P=0.278). Microbial culture results indicated that the proportion of qualified endoscopes in the experimental group (98.75%) was higher than that in the control group (93.75%), but the difference was not statistically significant (P=0.212). The bedside pre-cleaning time was significantly reduced in the experimental group30.00s vs. 76.00 (52.20, 117.50)s, P<0.001, as was the leak detection time77.50 (60.00, 129.50)s vs. 126.00 (112.50, 150.00)s, P<0.001. Manual verification of the machine's leak detection accuracy revealed only one detection deviation in the experimental group. CONCLUSION The cleaning effectiveness of the automated bedside washer is comparable to that of traditional manual operations, but the washer significantly reduces the time required for bedside pre-cleaning and leak detection, improving cleaning efficiency and suggesting its potential to replace traditional manual operations.