Balloon-assisted enteroscopy (BAE) enables diagnostic and therapeutic interventions for strictures, bleeding, and other pancreaticobiliary problems in patients with altered anatomy due to prior surgeries such as Billroth II or Rouxen- Y. It is essential to obtain accurate information about the previous surgery before performing endoscopic procedures using BAE in patients with surgically altered anatomy. Collaboration with the endoscopists who have expertise in pancreaticobiliary procedures is required when BAE is performed for the patients with pancreaticobiliary problems. If cecal intubation proves difficult with conventional colonoscopy with colonoscope or gastroscope, BAE may be considered, with both double-balloon and single-balloon types as viable choices. If colonoscopy and BAE is not possible, computed tomographic (CT) colonography can serve as an alternative.