The small intestine has, until 2001, been an organ largely inaccessible to conventional endoscopy. Since that time a variety of endoscopic technologies have become available that have transformed small bowel diagnosis and therapy with a concomitant increase in interest in this organ and its disorders. This issue is divided into two sections; first, the new technologies are presented and include video capsule endoscopy, single and double balloon enteroscopy, and very recently the innovative Spirus screw technology. An article on comparison of these new technologies and the evolving techniques of CT and MRI is included. Indications, contraindications, complications and therapeutic adjunctive devices are discussed. The second section addresses the application of these technologies to specific diseases and discusses how these technological advances have changed their management. An article on intra-operative enteroscopy and its utilization in this new era is included.