Regarding autopsy, small bowel (SB) metastases of cutaneous malignant melanoma (MM) often occur in advanced stages, but are rarely diagnosed in vivo. It is known that resection at this site can be especially beneficial regarding survival and palliation. For long time, the SB was kind of a "black box". SB capsule endoscopy (SBCE) was seen before to be sensitive in diagnosis of different lesions. This study reveals that it is also a good device regarding small bowel metastases (SBM) of MM, and what kind of relations exists involving (g)FOBT, thickness, stage, type of tumor, laboratory findings, etc. SBM were diagnosed often in stage IV with positive FOBT result (72.7%). Positive FOBT, tumor thickness, and high S100β blood serum level are independent prognostic factors for finding SBM of MM. A positive FOBT result was the strongest negative predictor for survival in stages III and IV. A diagnostic algorithm could be developed. Because of "silent" (s.s. not always bleeding) metastases, found especially in stage IV, intestinal exam incl. SBCE is useful there in any case of suspicion, non-regarding (g)FOBT result, but SBCE is crucial in stage III and IV when FOBT result is positive, and therapeutic consequences arise from diagnostics.