The inflammatory bowel disease (IBD) represents a complexmultifactorial disorder with distinct phenotypes that can becategorized by severity, location of the inflammation, extent andrisks of complications. IBD can also be characterized byresponsiveness to medical therapy. Traditionally, therapeuticapproach to IBD has been focused on pharmacologic agentsconsidered valuable for all patients, without taking into account theinterindividual differences. Personalized medicine in IBD is astrategy of diagnostic, therapeutic and monitoring approach of theindividual patients on the basis of their genetic background,disease mechanisms and other variable having a role in thedevelopment and progression of the disease. To accomplish thisaim, each patient will be categorized by means of biomarkers,pharmacogenomic studies, gut microbiota and immunologicalprofiles. Personalized medicine in IBD will become a crucial stepin the management of patients, allowing for selection of patientsfor specific therapies, successful monitoring and definition of riskin relation to the disease course. This could have beneficial effectson the disease course of each patient and on the National HealthSystem costs.