Endoscopy is the method of choice in diagnosing the cause of lower gastrointestinal bleeding, and it offers the opportunity to treat patients suffering from lower gastrointestinal bleeding. Endoscopic procedures must be integrated with other approaches to reach a correct diagnosis rapidly, safely, and economically. In all patients, evaluation begins with a history and physical examination. The sequence of other tests depends on many factors, especially the rate of bleeding. New technologies such as wireless capsule endoscopy will influence the management of patients with lower gastrointestinal bleeding.