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The article shows a histopathological review of inflammatory bowel disease (IBD) and the associated neoplasia. Its etiology is still not well defined and it involves genetic susceptibility, abnormalities in the gut epithelium, gut bacteria, and dysregulation of host’s immune response. Its incidence is higher in the developed world and is still growing. Most cases of IBD comprise ulcerative colitis and Crohn’s disease, and the remaining 5-15% involve indeterminate colitis. In the differential diagnosis, colitis induced by nonsteroidal antiinflammatory drugs, ischemic colitis, radiation colitis, infectious colitis, graft versus host disease, and colitis associated with diverticular disease need to be excluded. Patients with long-term disease have an increased risk of developing neoplasia and after 10 years with this disease the carcinoma risk increases by 1-2% each year.