The method of double-balloon endoscopy (DBE) introduced by Yamamoto permits noninvasive endoscopic evaluation of the small bowel while also providing therapeutic access. Specifically designed video endoscopes, Fujinon EN-580XP (slim type), Fujinon EN-580T (therapeutic type), and Fujinon EI-580BT (short therapeutic type) are produced by Fujifilm Corporation, Tokyo, Japan. The endoscope, with an attachable balloon at the tip, is used together with a soft overtube with another balloon at the distal end. To make insertion procedures safe and effective, soft latex balloons are used for both the endoscope and the overtube, and a specifically designed pump has been developed to inflate and deflate the balloons with one touch while accurately monitoring the balloon pressure. Most studies on small bowel endoscopy have been performed with DBE. They have shown DBE to be a safe and effective method allowing image enhancement, biopsy, and tattooing of lesions and providing therapeutic options like hemostasis with coagulation, or clipping, polypectomy, endoscopic mucosal resection, hydrostatic balloon dilatation, stent placement, and foreign body removal. Furthermore, endoscopic retrograde cholangiopancreaticography in surgically altered anatomy is increasingly performed. Thus, DBE has distinct advantages that can complement the limitations of small bowel capsule endoscopy. DBE may eliminate the need for intraoperative enteroscopy in many patients.