Inflammatory Bowel Disease (IBD) has become a global disease. The increasing incidence of inflammatory bowel disease across the world is challenging the traditional view of IBD as a western disease and represents a unique opportunity to gain an understanding of the disease in diverse ethnic groups and in different socio-economical and geographical environments. However, the continued growth in prevalence in developing countries in the coming years will lead to increased use of health-care resources due to IBD-related complications, costs of drugs and indirect health costs. Here we analyze the challenges and opportunities that this situation represents and suggest actions and potential solutions to improve the quality of IBD care globally.