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Background and objectives: Video-capsule endoscopy (VCE) has shown a large range (38&ndash, 83%) of diagnostic yield in unexplained iron deficiency anemia (IDA) and obscure-occult bleeding. Therefore, we retrospectively investigated the VCE-detected spectrum and the prevalence of small bowel injuries and associated risk factors in inpatients with both of the above reported conditions. Methods: We selected inpatients with IDA (hemoglobin &lt, 12 g/dL in women, &lt, 13 g/dL in men) and obscure-occult bleeding. We excluded VCE indications other than IDA. Complete medical histories and laboratory tests were collected. All subjects underwent PillCam SB2/SB3. The VCE feature Lewis score was calculated when appropriate. We used the t-test and Fisher&rsquo, s exact test for continuous and categorical variables, respectively, in univariate analysis. For multivariate analysis, we used binomial logistic regression. Results: We retrieved 109 patients (female:male ratio of 53:56, age 63.4 &plusmn, 18.9 years). Eighty patients (73.4%) showed &ge, 1 small bowel lesions. The Lewis score was calculated in 41 patients: 13 (31.7%) showed a mild (&lt, 135) and 28 (68.3%) a moderate-severe (135&ndash, 790 and &gt, 790, respectively) score. In univariate analysis, the small bowel transit time (6.2 &plusmn, 2.9 versus 5.2 &plusmn, 2.1 h, p = 0.049) and non-steroidal anti-inflammatory drug use for at least two weeks (17.5% versus 0%, p = 0.01) were significantly higher in subjects with injuries. These associations were not confirmed at multivariate analysis. The severity of a lesion directly correlated with proton pump inhibitor (PPI) use and duration (not confirmed in multivariate analysis). VCE can reveal the source of obscure-occult bleeding in a high percentage of unexplained IDAs. A wide spectrum of endoscopic pictures may be found. Known as well as supposed risk factors for small bowel lesions may be detected.