The diagnosis and management of inflammatory bowel disease (IBD) principally depends on the clinical presentation and findings on imaging studies. The main tools for diagnostic imaging in IBD are radiologic and endoscopic. Contrast radiography and computed tomography (CT) scanning are the most common radiologic tests. Luminal radiography provides information about the localization, extent, contiguity, and in some cases severity of disease throughout the digestive tract but principally in the small bowel and colon. CT scanning offers cross-sectional imaging to assess luminal as well as extraluminal disease activity. Endoscopy may include flexible sigmoidoscopy, colonoscopy, and esophagogastroduodenoscopy (EGD). In addition to allowing direct inspection of the luminal mucosa, endoscopy offers the ability to sample tissue from normal-appearing and abnormal-appearing areas. In patients presenting with a clinical history suggestive of IBD, the differential diagnosis includes infectious, neoplastic, secretory, ischemic and functional disorders. Diagnostic imaging is important in establishing or excluding discrete diagnoses that may be amenable to specific therapies and in discriminating ulcerative colitis from Crohn's disease. Imaging may also play a limited role in assessing response to therapy and in this manner is used adjunctively in clinical management. This article discusses the role of imaging studies in the diagnosis and management of IBD. The evaluation of suspected complications associated with IBD, including stricture and fistulous disease, as well as surveillance for colorectal cancer is also discussed. An overview of radiographic studies is followed by a treatment of endoscopic indications and findings. The use of imaging studies in the differential diagnosis and management of IBD is integrated in the endoscopic section.