There has been an ongoing expansion in available biologic and small molecule therapies to treat moderate to severe ulcerative colitis (UC). The sequence in which these therapies are used has been a topic of high interest among clinicians. In the absence of precision medicine for UC, it would be useful to define the sequence of therapies that may predict the best outcomes. Limited data exists regarding the most effective treatment algorithms for achieving optimal patient outcomes. As such, this study endeavors to identify treatment algorithms when considering the UC therapies of vedolizumab, infliximab, ustekinumab, and tofacitinib.