OBJECTIVE: The global prevalence of inflammatory bowel disease (IBD) is increasing rapidly, and its systemic inflammation and immune dysregulation may affect surgical outcomes. However, the impact of IBD on perioperative complications in cervical spine fusion has never been reported. This study aimed to investigate the association between IBD and perioperative complications of cervical spine fusion using the National Inpatient Sample (NIS) database and analyze the related risk factors. METHODS: Data from patients undergoing cervical spine fusion between 2010 and 2019 were extracted using ICD-9-CM and ICD-10-CM codes. Patients under the age of 18 were excluded. Patients were grouped based on the presence or absence of IBD, and demographic, hospital, comorbidity, and perioperative complication data were compared. Statistical analyses included Pearson's chi-squared test, Wilcoxon rank-sum test, and logistic regression. RESULTS: A total of 350,775 patients who underwent cervical spine fusion were enrolled, with 1,838 (0.52%) having comorbid IBD. The prevalence of IBD increased from 0.4% in 2010 to 0.8% in 2019. The presence of IBD was associated with an increased risk of specific perioperative complications, including dysphagia (odds ratio [OR] = 1.49), urinary tract infection (OR = 1.31), acute kidney injury (OR = 1.87), sepsis (OR = 1.51), pulmonary embolism (OR = 2.40), and acute myocardial infarction (OR = 2.04). CONCLUSIONS: The prevalence of IBD among patients undergoing cervical spine fusion is increasing, and patients with IBD face higher risks of specific perioperative complications. Spine surgeons should conduct more detailed risk assessments and adjust perioperative management accordingly.