Exhibit 12.1

CERTIFICATION UNDER SECTION 302 OF THE
SARBANES-OXLEY ACT

I, Nachum
Shamir, certify that:

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| | 1. | I have
  reviewed this annual report on Form 20-F of Given Imaging Ltd.;                                                                                                                                                                                                                                                                                                             
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| | 2. | Based on my
  knowledge, this annual report does not contain any untrue statement of a
  material fact or omit to state a material fact necessary to make the
  statements made, in light of the circumstances under which such statements
  were made, not misleading with respect to the period covered by this report;                                                            
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| | 3. | Based on my
  knowledge, the financial statements, and other financial information included
  in this report, fairly present in all material respects the financial
  condition, results of operations and cash flows of the company as of, and
  for, the periods presented in this report;                                                                                         
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| | 4. | The
  companys other certifying officers and I are responsible for establishing
  and maintaining disclosure controls and procedures (as defined in Exchange
  Act Rules 13a-15(e) and 15d-15(e)) and internal control over financial reporting
  (as defined in Exchange Act Rules 13a-15(f) and 15d-15(f)) for the company
  and have:                                            
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| | a) | Designed
  such disclosure controls and procedures, or caused such disclosure controls
  and procedures to be designed under our supervision, to ensure that material
  information relating to the company, including its consolidated subsidiaries,
  is made known to us by others within those entities, particularly during the
  period in which this report is being prepared;
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| | b) | Designed
  such internal control over financial reporting, or caused such internal
  control over financial reporting to be designed under our supervision, to
  provide reasonable assistance regarding the reliability of financial
  reporting and the preparation of financial statements for external purposes
  in accordance with generally accepted accounting principles;   
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| | c) | Evaluated
  the effectiveness of the companys disclosure controls and procedures and
  presented in this report our conclusions about the effectiveness of the
  disclosure controls and procedures, as of the end of the period covered by
  this report based on such evaluation;                                                                                                 
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| | d) | Disclosed in
  this report any change in the companys internal control over financial
  reporting that occurred during the period covered by the annual report that has
  materially affected, or is reasonably likely to materially affect, the
  companys internal control over financial reporting; and                                                                         
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| | 5. | The
  companys other certifying officers and I have disclosed, based on our most
  recent evaluation of the internal control over financial reporting, to the
  companys auditors and the audit committee of the companys board of
  directors (or persons performing the equivalent functions):                                                                                  

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| | a) | All
  significant deficiencies and material weaknesses in the design or operation
  of internal control over financial reporting which are reasonably likely to
  adversely affect the companys ability to record, process, summarize and
  report financial information; and
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| | b) | Any fraud,
  whether or not material, that involves management or other employees who have
  a significant role in the companys internal control over financial
  reporting.                                                                                                 

Date:
May 16, 2007

/s/ Nachum
Shamir
Nachum Shamir
President and Chief Executive Officer

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