In the last decade, substantial gains have been made in the treatment of inflammatory bowel disease (IBD). Refinements in drug formulation have provided the ability to target distinct sites of delivery, enhancing the safety and efficacy of older agents. Immunosuppressive agents beyond corticosteroids have assumed a routine part in the care of patients with IBD. Moreover, as the century closes, we stand at the threshold of unprecedented advances in knowledge of the pathogenesis of ulcerative colitis and Crohn's disease. Simultaneous progress in biotechnology has fostered the development of new agents that strategically target pivotal processes in disease pathogenesis. This review covers agents currently used in the treatment of IBD and seeks to provide an overview of emerging therapies.