There is growing interest in the use of biologic therapy early in the course of Crohn's disease. In this issue, Schreiber et al. use data from the PRECISE trials to demonstrate a greater response to certolizumab in patients with shorter duration of disease. This suggests that early treatment prior to the occurrence of significant tissue remodeling and irreversible cumulative bowel damage may result in better outcomes. This editorial describes the data published so far on the correlation between disease duration and treatment response and examines the potential benefits to such treatment algorithms.