Small bowel and colonic motility disorders may be primary (visceral neuropathy or myopathy), which may be inherited or sporadic. Several systemic disorders such as diabetes mellitus, systemic sclerosis may cause secondary small intestinal motility disorders. Small intestinal motility disorders diagnosed in the clinical practice may be the tip of the iceberg as many patients may remain asymptomatic or may have trivial symptoms mimicking “functional” bowel disease such as irritable bowel syndrome. Though imaging such as abdominal radiograph, barium small bowel series, and computerized tomography may show dilated gut without mechanical narrowing, antroduodenal manometry, though not available widely, is able to diagnose and differentiate between visceral neuropathy and myopathy. Investigations that help to detect the extent of the involvement of gut, extra-gastrointestinal organs and etiology include esophageal manometry, gastric emptying studies, electrogastrography, colon transit study, autonomic function test, uroflowmetry, investigations to diagnose small intestinal bacterial overgrowth, and systemic diseases such as diabetes mellitus, hypothyroidism, systemic sclerosis etc. Treatment is dependent on etiology, severity, and extent of involvement and includes nutritional support, prokinetics, rifaximin for small intestinal bacterial overgrowth, and small intestinal transplantation in the advanced stage of the disease.