AIM:To compare the diagnostic yield of capsule endoscopy (CE) with that of double-balloon enteroscopy (DBE). METHODS:Pubmed,Embase,Elsevier ScienceDirect,the China Academic Journals Full-text Database,and Cochrane Controlled Trials Register were searched for the trials comparing the yield of CE with that of DBE. Outcome measure was odds ratio (OR) of the yield. Fixed or random model method was used for data analysis. RESULTS:Eight studies (n = 277) which prospectively compared the yield of CE and DBE were collected. The results of meta-analysis indicated that there was no difference between the yield of CE and DBE 170/277 vs 156/277,OR 1.21 (95% CI:0.64-2.29). Based on sub analysis,the yield of CE was significantly higher than that of double-balloon enteroscopy without combination of oral and anal insertion approaches 137/219 vs 110/219,OR 1.67 (95% CI:1.14-2.44),P < 0.01),but not superior to the yield of DBE with combination of the two insertion approaches 26/48 vs 37/48,OR 0.33 (95% CI:0.05-2.21),P > 0.05). A focused meta-analysis of the fully published articles concerning obscure GI bleeding was also performed and showed similar results wherein the yield of CE was significantly higher than that of DBE without combination of oral and anal insertion approaches 118/191 vs 96/191,fixed model:OR 1.61 (95% CI:1.07-2.43),P < 0.05) and the yield of CE was significantly lower than that of DBE by oral and anal combinatory approaches 11/24 vs 21/24,fixed model:OR 0.12 (95% CI:0.03-0.52),P < 0.01). CONCLUSION:With combination of oral and anal approaches,the yield of DBE might be at least as high asthat of CE. Decisions made regarding the initial approach should depend on patient’s physical status,technology availability,patient’s preferences,and potential for therapeutic endoscopy. AIM: To compare the diagnostic yield of capsule endoscopy (CE) with that of double-balloon enteroscopy (DBE). METHODS: Pubmed, Embase, Elsevier Science Direct, the China Academic Journals Full-text Database, and Cochrane Controlled Trials Register were searched for the trials comparing the yield of CE with that of DBE. Outcome measure was odds ratio (OR) of the yield. The results of meta-analysis indicate that there was no difference between the yield of CE and DBE 170/277 vs 156/277, OR 1.21 (95% CI: 0.64-2.29). Based on sub analysis, the yield of CE was significantly higher than that of double-balloon enteroscopy without combination of oral and anal insertion approaches 137/219 vs 110/219, OR 1.67 (95% CI: 1.14-2.44, P <0.01) but but superior to the yield of DBE with combination of the two insertion approaches 26/48 vs 37/48, OR 0.33 (95% CI: 0.05-2.21), P> 0.05). A focused meta-analysis of the total published articles concerning obscure GI bleeding was also performed and were similar in the yield of CE was significantly higher than that of DBE without combination of oral and anal insertion approaches 118/191 vs 96/191, fixed model: OR 1.61 (95% CI: 1.07-2.43), P <0.05) and the yield of CE was significantly lower than that of DBE by oral and anal combinatory approaches 11 / 24 vs 21/24, fixed model: OR 0.12 (95% CI: 0.03-0.52), P <0.01 CONCLUSION: With combination of oral and anal approaches, the yield of DBE might be at least as high asthat of CE. Decisions made regarding the initial approach should depend on patient’s physical status, technology availability, patient’s preferences, and potential for therapeutic endoscopy.