Introduction: Colonoscopies remain the gold standard in helping identify and remove pre-cancerous and malignant polyps. The adenoma detection rate (ADR) is a recognized quality metric to assess screening colonoscopies. Few studies have examined associations between ADR and both bowel prep quality as assessed by the Boston Bowel Prep Score (BBPS) and socioeconomic factors. Methods: We performed a single-center, retrospective study on all outpatient colonoscopies from 1 July 2017 to 31 December 2017 at our institution. We excluded colonoscopies that did not document BBPS. We dichotomized the cohort into those with neoplastic polyps and those with non-neoplastic polyps. We used the t-test to analyze the continuous variables comprising each group (Table 1) and the Fisher's exact test to investigate associations between categorical variables and ADR (Table 2). A test level of 0.05 was considered significant. All analyses were conducted in R version 3.4.2 (R Core Team 2017, Vienna, Austria). Results: We identified 1081 patients who had undergone outpatient colonoscopies by 11 different endoscopists at our institution. Of these, 388 (35.6%) reported a BBPS. Neoplastic polyps were identified in 145/388 patients (60%). Anemia was significantly associated with increased ADR. ADR was higher in men than in women, but this difference was not statistically significant. We found no statistically significant differences in ADR based on sex, ethnicity, insurance type, BBPS, history of diabetes, smoking, or chronic renal disease. We also noted a trend toward significantly higher ADR with low-volume (2.9L) bowel preparation compared to the high-volume (4L) one. Conclusion: Anemia was significantly associated with increased ADR. This is likely due to endoscopists' increased scrutiny in patients with this condition as well as the possibility that the anemia was due to underlying neoplastic lesions. ADR was not associated with either high or low BBPS. This finding is likely due to the limited sample size and it is contrary to what prior studies with similar observational designs have found. Increasing ADR with low-volume bowel preparation may reflect improved compliance with consumption. Prospective randomized studies and additional larger retrospective studies are needed to evaluate these findings.