As postoperative changes can cause difficulties in the interpretation of small bowel capsule endoscopy (SBCE), knowledge of these differences is as important as in radiology. It is not uncommon to examine patients who have had a previous fundoplication, some type of gastrectomy, a partial small bowel resection, or an ileocecal resection, and increasingly after gastric bypass surgery. The findings obtained with SBCE, especially at anastomotic sites, are often less than spectacular, mostly demonstrating portions of the anastomosis. As SBCE cannot visualize afferent loops, a complete small bowel inspection requires additional flexible enteroscopy. Knowledge of previous endoscopic interventions is crucial for correct interpretation of findings. Furthermore, SBCE can be used to monitor patients after intestinal transplant.