Obscure gastrointestinal bleeding (OGIB) is a consolidated indication to capsule endoscopy (CE), which when used as a first-line exploration is the most efficient strategy as regards diagnosis in these patients. Patient selection and timing of the procedure are of paramount importance in the high diagnostic yield of CE. When integrated into a global patient care plan, CE is helpful in achieving effective decision-making concerning subsequent investigations and treatments. Although most studies appear to indicate a positive influence of CE diagnosis on clinical outcome of patients who have OGIB, large prospective trials are warranted to assess what is the most effective therapeutic strategy in patients with vascular lesions.