Endoscopy plays a pivotal role in managing inflammatory bowel disease (IBD). The role of endoscopy has evolved over the years, from diagnostic to surveillance to now doing therapeutic procedures to manage patients with IBD. From the initial diagnostic endoscopy, describing the extent and severity of the disease is an essential step in differentiating between Crohn's disease and ulcerative colitis. Patients with IBD frequently undergo surgeries, and understanding various postoperative configurations and performing endoscopy in postoperative patients can pose a challenge. A thorough understanding of the same can help us to assess disease activity and manage our patients. The purpose of this review was to provide an overview of the role of endoscopy in the management of IBD and to examine various anatomical variations in patients postoperatively.