The incidence of inflammatory bowel disease (IBD) is increasing worldwide and poses a huge economic burden. The disease is difficult to treat and prone to recurrence, which seriously affects the physical and mental health of patients. Several studies have shown that natural polysaccharides have significant advantages in IBD treatment. To improve the therapeutic efficacy and broaden the scope of its application, numerous studies on various polysaccharide derivatives for IBD treatment have been published, showing broad application prospects. This paper reviews studies on various chemically modified polysaccharides, including carboxymethylation, sulfation, acetylation, esterification, thiolation, glycosylation, and polysaccharide metal complexes, in IBD treatment. These studies revealed the mechanism of action of polysaccharide derivatives and contributed to the development of related drug delivery systems, providing new strategies for IBD treatment. The advantages and disadvantages of each type of polysaccharide derivatives are discussed in this paper, aiming to provide a scientific basis for optimizing future IBD therapeutic regimens and exploring the potential application of polysaccharide derivatives as IBD therapeutic agents.