Suspected or known GI stenosis is a contraindication unless intestinal patency is proven. The risk for capsule retention should be assumed in patients with known Crohn’s disease, clinical or radiologic signs of obstruction, a history of abdominal-pelvic radiation, and after small bowel resection. Patients undergoing video capsule endoscopy (VCE) for suspected small bowel bleeding without the above risks do not require preceding radiology or a patency capsule. GI motility disorders without underlying stenosis are no contraindication for video capsule endoscopy (VCE). The routine use of a real-time viewer directly after swallowing the capsule and after an hour enables the detection of aspiration and esophageal or gastric retention and consecutive intervention if necessary. In case of swallowing disorder, the capsule should be placed endoscopically. Implanted cardiac pacemakers, defibrillators, and left heart assist devices are a formal contraindication by manufacturers of wireless capsules but not in clinical practice. Pregnancy is a contraindication, VCE should be postponed after delivery.