Crohn's disease and ulcerative colitis are chronic, progressive, destructive and disabling conditions. So far therapeutic strategies based only on the relief of symptoms did not change the natural history of inflammatory bowel diseases (BD). In Crohn's disease the concept of deep remission, which includes clinical and inflammatory (endoscopic and biologic) remission, is emerging. In ulcerative colitis, evidence accumulates to recommend achieving and maintaining mucosal healing as assessed by proctosigmoidoscopy. Whether histologic remission is the ultimate therapeutic goal in ulcerative colitis will require further investigation. These new therapeutic targets may be the best way to change disease course (hospitalizations, surgery) and to prevent disability in IBD.