Abstract: An endoscopic sheath holding tip and stabilization system is configured to be connected to a table mounted flexible or rigid arm or other surgical support device used over the patient during a surgical procedure. The sheath holder includes a hook structure configured to engage the underside of the scope sheath (e.g., inflow and outflow ports), while a plunger mechanism engages the top surface of the sheath. The downward pressure of the plunger mechanism working against the upward forces of the hook structure operate to stabilize the scope sheath without requiring user intervention. In this manner, the scope and other instruments can be introduced into the stabilized scope sheath without requiring user assistance to hold the scope once positioned in the stabilized sheath.