Crohn’s disease (CD) is a chronic inflammatory bowel disease with a progressive course in the majority of patients. Complications such as strictures and fistulas and consequently hospitalization and surgery may occur increasingly over time. Early treatment reduces complications, and mucosal healing has a positive prognostic effect. Video capsule endoscopy (SBCE) confirms diagnosis in endoscopy-negative small intestinal bowel CD, determines the extent of small bowel involvement, and improves diagnosis in established CD. Moreover, SBCE is a valuable tool for evaluation of small intestinal mucosal healing at follow-up examinations under medical and/or surgical therapy. The use of inflammatory scores is helpful in these cases. In unclear situations, SBCE may help clarify whether escalation or de-escalation in drug therapy is favorable. The use of SBCE in CD is limited by capsule retention which may be severe if the capsule gets stuck in long inflammatory strictures.