Routine endoscopy of the small bowel has found its way into clinical practice within the last few years. Capsule endoscopy (CE) enables with high accuracy detection of the source of mid intestinal bleeding. Crohn's disease of the small bowel is sensitively detected and surveillance in polyposis syndromes is improved by applying sensitive, non-invasive endoscopic means. Double-balloon enteroscopy (DBE) may be used complementary to CE by offering therapeutic possibilities and providing histopathological specimen. This review describes the diagnostic and therapeutic repertoire that is offered by modern small bowel endoscopy.