The paradigm of video capsule endoscopy (VCE) is changing. Once dismissed as a pipedream, VCE has overcome technological constraints and perceptions of limited demand and established itself as an important tool in the practicing gastroenterologist’s panoply. Introduced to the public in 2001, VCE has proliferated over the past two decades to become a standard diagnostic test for a multitude of diseases, including small bowel bleeding (SBB), Crohn’s disease (CD), and small intestinal neoplasia. Newer platforms are no longer limited to the small intestine alone, with recent developments introducing esophageal capsule endoscopy (ECE) and colon capsule endoscopy (CCE). In the near future, VCE is also poised to revolutionize the approach to gastrointestinal bleeding (GIB) in the acute care setting. Indeed, capsule endoscopic technologies have come far since their debut in 2001 and, with more hardware and software advancements on the horizon, show no sign of abating.