Wireless video capsule endoscopy has emerged as the first-line diagnostic tool for the small bowel. Technical improvements include image quality, prolonged battery life, and adaption of frame rate via bidirectional signal transmission. Magnetic controlled capsule endoscopy of the stomach is possible by means of external magnets. Even robotic actuation of a video capsule automatically controlled by real-time image analysis with artificial intelligence is possible. Research is focusing on controlled active internal locomotion of video capsules and on external electromagnetic controlled actuation in the small bowel and colon. Localization is crucial for active steering of capsule movements. Information can be based on the analysis of received signal, external electromagnetic systems, and analysis of generated endoscopic images. Implementation of additional diagnostic modalities such as ultrasound, endomicroscopy, autofluorescene, and virtual chromoendoscopy has been shown to be feasible in prototypes. Different sensors for pH, pressure, temperature, blood, bioelectric sensing, and different types of gas are implemented in commercially available capsules or in prototypes. Therapeutic options as clip deployment, biopsies, fine-needle aspiration, and tattooing are further research areas. As power consumption is a crucial issue, given space constraints of a swallowable capsule, several attempts for optimization are made. This includes low power circuits, transmitters, and optical chips. Chips with on board intelligence aim to reduce the necessary data stream. This chapter gives an overview of various approaches on present and future developments and refinement of components in VCE.