ABSTRACT Immune checkpoint inhibitors (ICIs) have emerged as a cornerstone of cancer immunotherapy but are associated with immune‐mediated adverse events (imAEs), including gastrointestinal toxicities. Among these, enteritis is a less common but clinically significant complication. However, small intestinal involvement remains under‐recognized, and endoscopic findings are not well characterized. We report four cases of imAE enteritis in which small‐bowel capsule endoscopy (SBCE) was performed. SBCE revealed variable mucosal abnormalities, including villous atrophy, aphthous ulcers, and extensive erosions; in one case, deep circumferential ulcers with stricture were observed. While one patient responded to corticosteroids, the other three required escalation to biologic therapy due to steroid‐refractory disease. These findings suggest that SBCE may play a valuable role in assessing disease extent and predicting treatment responsiveness in imAE enteritis. Early utilization of SBCE could facilitate timely therapeutic decision‐making in affected patients.
