Introduction: Wireless Capsule Endoscopy (WCE) provides direct visualization of mucosal abnormalities throughout the entire small intestine. IBD serologies have been shown to be a useful marker in IBD. The combination of WCE with IBD serologies may be the most sensitive means of diagnosing and identifying the extent and degree of small intestinal Crohn's disease (CD). Methods: A retrospective analysis of 86 patients who underwent WCE with the PillCam Sb (Given Imaging, Yoqneam, Israel) for suspected CD between January 2003 and November 2005. 4 groups of patients were identified: 28 with abdominal pain, diarrhea, guaiac + stools, and iron deficiency anemia; 24 with abdominal pain and diarrhea; 11 with abdominal pain; 23 with indeterminate colitis. All patients underwent pan-endoscopy, most ileoscopy, and small bowel series. WCE studies were reviewed by 2 independent readers. Findings were classified as definite or possible for CD, non-specific, or normal. Definite findings included the presence of greater than 3 ulcers, numerous aphthous ulcers, edema, nodularity, and stricture. Findings considered as possible included the presence of a single aphthous ulcer with edema and nodularity. Non-specific inflammatory changes consisted of erythema, edema, nodularity, and mucosal breaks. IBD serologies (ASCA IgA, IgG, p-ANCA) were obtained from 52 patients. Patients on aspirin, clopidogrel, NSAIDs, or with known CD, were excluded. Results: There were 53 females, 33 males; average age 47.4 (range 11-82). 9/28 patients with abdominal pain, diarrhea, guaiac + stools, and iron deficiency anemia had definite Capsule Endoscopy findings (4 with diffuse small intestinal involvement), 5 possible, 11 non-specific, 3 normal. 3/24 patients with abdominal pain and diarrhea had definite findings, 6 possible, 13 non-specific, 2 normal. 1/11 patients with abdominal pain alone had definite findings (diffuse small intestinal involvement), 2 possible, 8 non-specific. 4/23 patients with indeterminate colitis had definite findings, 6 possible, 7 non-specific, 6 normal. 84% (16/19) of patients with + IBD serologies had definite or possible capsule findings; 10/12 patients with definite findings had + markers; 6/15 with possible findings had + markers; 2/21 with non-specific findings had + markers; 1 with normal findings had + markers. Conclusion: + WCE findings for CD strongly correlated with + IBD serologies. + WCE findings for CD were highest for patients with abdominal pain, diarrhea, guaiac + stools, and iron deficiency anemia. Combining WCE with IBD serologies improves the diagnostic staging of patients with CD. This may ultimately impact on therapy.