Factors influencing reading time and detection of lesions include the view mode (VM) and frame rate (FR) applied during reading of small bowel capsule endoscopy images. The aims of this study were to examine the impact of VM and FR on reading time and lesion detection using a standardized, single-type lesion model. A selected video clip containing a known number of positive images (n = 60) of small bowel angioectasias was read using nine different combinations of VM and FR (VM1, VM2, and VM4 × FR10, FR15, and FR25) in randomized order by six capsule endoscopists. Readers were asked to count all positive images of angioectasias (maximum number of positive images, MPIs) seen during reading. The main outcome measurements were effect of VM and FR on reading time and lesion detection. Mean MPIs for all VM2 and VM4 were 36 (60 %) and 38 (64 %). They were significantly higher than VM1 of 24 (40 %) (P = 0.011, 0.008). A statistical difference was found when the total MPIs at FR10 were compared to FR15 (P = 0.008) and to FR25 (P < 0.001). Both VM and FR significantly influence lesion detection during capsule endoscopy reading.