The surgical and medical management of inflammatory bowel disease (IBD) has significantly evolved over the course of the last two decades. On the medical side, the introduction of biologic therapy has significantly changed the characteristics of the patients undergoing surgery for Crohn's disease (CD), while its impact on the need for surgical intervention and the surgical outcomes of these patients is still debated. On the surgical side, the introduction of and the growing experience with minimally invasive approaches to IBD have had a significant impact on outcomes and quality of life in this patient population. During the past three decades the evidence has been accumulating in favor of a minimally invasive approach to CD. Clearly, this is probably one of the most challenging diseases to treat laparoscopically for the colorectal surgeon, especially when the disease is located in the colon and involves multiple segments.