A case of acute perforation of the small bowel in a 32-year-old man with Crohn's disease not previously diagnosed is presented. The patient underwent an emergency bowel resection and anastomosis and was put on 5-ASA for the following 4 years. No clinical or endoscopic recurrences appeared during this period. In order to avoid both functional disorders and recurrences, a surgical treatment based on resection and anastomosis in minor risk cases, i.e. in patients without abscess and/or concurrent steroid therapy, and on resections limited to grossly involved segments of bowel is advocated.