Video capsule endoscopy is a major innovation that provides high-resolution imaging of the entire small intestine in its entirety. In the 4 years since its introduction, capsule endoscopy has demonstrated its viability as a first-line investigation in patients with obscure gastrointestinal bleeding after a negative esophagogastroduodenoscopy and colonoscopy, and it has a positive impact on the outcome. Video capsule endoscopy is also useful in the evaluation of inflammatory and neoplastic disorders of the small bowel. Its role in children and in the evaluation of esophageal disorders is currently being explored and defined.