Participants were managed using either the conventional AI-enabled fluoroscopy system or the newly designed LE-AIF system. Key Findings:The lead flap-enhanced, AI-enabled fluoroscopy (LE-AIF) system significantly reduced radiation scatter exposure for both endoscopists and anesthesia personnel compared with the conventional fluoroscopy setup. Use of the conventional AI-enabled fluoroscopy system was independently associated with higher radiation scatter exposure. The enhanced fluoroscopy system may offer a practical way to improve workplace safety by lowering cumulative radiation exposure. The study concluded that the lead flap-enhanced, artificial intelligence-enabled fluoroscopy system significantly reduced radiation scatter during fluoroscopy-guided endoscopic procedures.