The incidence of inflammatory bowel diseases (IBD) is increasing globally, outpacing what genetic influences alone could instigate and implicating complex interactions with environmental factors including the gut microbiome in its elusive aetiology. We are also witnessing a period of unprecedented advances in its aetiopathogenesis, with important discoveries. Meanwhile, our expanding therapeutic armamentarium and the exciting implications of what can be achieved through abrogation of immune-inflammatory events such as mucosal healing, and reduction in hospitalization, surgery and colorectal neoplasia have redefined our perceptions of meaningful disease control.