A 30-year-old woman was referred to our hospital with recurrent refractory ulcerative colitis. She also suffered from avascular necrosis of the left femoral head caused by steroid use. We had expected that tacrolimus would contribute to remission, but effects remained insufficient even after 16 days of treatment. Intensive leukocytapheresis (LCAP) therapy was added to tacrolimus therapy, and this combination achieved remission. Tacrolimus plus intensive LCAP combination therapy appears useful in treating refractory ulcerative colitis.