BACKGROUND: Tumor necrosis factor alpha (TNF-alpha) inhibitors are widely used in the treatment of inflammatory bowel disease (IBD), but there is still a lack of systematic risk assessment for pulmonary toxicity. METHODS: We calculated the pulmonary-related risk signals for four TNF-alpha inhibitors using the disproportionality analysis and also compared them with the pulmonary-related signals of seven other therapies. RESULTS: There were 8736 reports of pulmonary-related adverse events (AEs) to TNF-alpha inhibitors as the 'primary suspect (PS)' therapies. The median time to incident for pulmonary-related AEs was 148 (interquartile range [IQR] 21-721) days. TNF-alpha inhibitors exhibited the strongest signal of pulmonary toxicity compared to Interleukin 12/23 (IL-12/23) inhibitors, Integrin blockers, Jak inhibitors, and S1P receptor modulator. Golimumab exhibited the strongest signal compared to infliximab, certolizumab pegol, and adalimumab. The strongest signal corresponding to pneumonia, pulmonary tuberculosis, asthma, chronic obstructive pulmonary disease (COPD), pulmonary thrombosis, and pulmonary fibrosis is golimumab, infliximab, infliximab, natalizumab, upadacitinib, and adalimumab. CONCLUSIONS: TNF-alpha inhibitors had the strongest signal of pulmonary toxicity relative to other control therapies. Golimumab had the strongest signal of pulmonary toxicity relative to other TNF-alpha inhibitors. When TNF-alpha inhibitors are used in the treatment of IBD, pulmonary-related AEs should be vigilant.