Treatment options for inflammatory bowel disease (IBD) have expended tremendously in the past two decades. Biologics have now been increasingly used early in the course of therapy with the goal of inducing remission and thus delaying or avoiding the need for surgery. In spite of these advances, approximately 1/3rd of the patients with ulcerative colitis (UC) and 70% of those with Crohn’s disease (CD) undergo surgery over their lifetime. Comparative data of different biologics regarding surgical outcomes are relatively sparse outside of the clinical trials.