Background: Wireless capsule endoscopy (WCE) offers endoscopic access to the small bowel and may therefore change diagnostic and therapeutic strategies in sm all bowel diseases. Aim: The aim of this prospective study was to validate the g ain in information and therapeutic impact of WCE in patients with Crohn’ s disease. Methods: Fifty six consecutive patien ts with Crohn’ s disease underwent computed tomography (CT) enteroclysis, and i f stenoses < 10 mm were excluded, WCE was carried out. Results: In 15 patients ( 27% ), WCE could not be performed due to strictures detected by CT enteroclysis . From the other 41 patients, jejunal or ileal lesions were found in 25 patients by WCE compared with 12 by CT enteroclysis (p = 0.004). This gain in informatio n was mainly due to detection of small mucosal lesions such as villous denudatio n, aphthoid ulcerations, or erosions. Both methods were not significantly differ ent in the detection of lesions in the terminal/neoterminal ileum (WCE 24 patien ts, CT enteroclysis 20 patients). Therapy was changed due to WCE findings in 10 patients. Consecutively, all of them improved clinically. Conclusions: Capsule e ndoscopy improves the diagnosis of small bowel Crohn’ s disease. This may have significant therapeutic impact. Background: Wireless capsule endoscopy (WCE) offers endoscopic access to the small bowel and may therefore change diagnostic and therapeutic strategies in sm all bowel diseases. Aim: The aim of this prospective study was to validate the gin in information and therapeutic impact of WCE in patients with Crohn’s disease. Methods: Fifty six consecutive patien ts with Crohn’s disease underwent computed tomography (CT) enteroclysis, and if stenoses <10 mm were excluded, WCE was carried out. Results: In 15 patients ), WCE could not be performed due to strictures detected by CT enteroclysis. From the other 41 patients, jejunal or ileal lesions were found in 25 patients by WCE compared with 12 by CT enteroclysis (p = 0.004). This gain in informatio n was mainly due to detection of small mucosal lesions such as villous denudatio n, aphthoid ulcerations, or erosions. Both methods were not significant differ ent in the detection of lesions in the terminal / neoterminal ileum (WCE 24 p atien ts, CT enteroclysis 20 patients). Therapy was changed due to WCE findings in 10 patients. Consecutively, all of them improved clinically. Conclusions: Capsule e ndoscopy improves the diagnosis of small bowel Crohn’s disease. This may have significant therapeutic impact .